Abstract: Objective: To review and analyze the value of various severity scale system for predicting 30 day mortality and ICU admission in community acquired pneumonia (CAP) patients via meta-analysis. Methods: MEDLINE and EMBASE (2004-2015) were retrieved and 48 papers were collected. Altogether 51 639 CAP patients were enrolled for predicting 30 day mortality, and 10 590 CAP patients were enrolled for predicting ICU admission. The values of five severity scale system: CRB-65, CURB-65, PSI, 2007 IDSA/ATS, SMART-COP for predicting 30 day mortality and ICU admission were meta-analyzed. Results: For predicting 30 day mortality, CRB-65 had a sensitivity of 98%; specificity of 33% and area under summary receiver operator characteristic (sROC) curve (AUC) 0.56. For CURB-65, the above mentioned indices were 84%, 55% and 0.78, respectively. PSI(pneumonia severity index) had a sensitivity of 90%, specificity of 57% and area under sROC curve 0.88; the above mentioned indices for 2007 IDSA/ATS were 76%, 90% and 0.89, respectively. For predicting ICU admission. CURB-65 had a sensitivity of 52%, specificity of 77% and area under sROC 0.67; the above mentioned indices for PSI were 70%, 61%and 0.69, respectively. The SMART-COP had a sensitivity of 84%, specificity of 70%, and area under sROC curve 0.74. Conclusions: PSI, CURB-65 could be used as important references for predicting 30 day mortality in patients with CAP. For ICU admission, the prediction value of SMART-COP is relatively better than PSI and CURB-65 scale systems.

Key words: Community-acquired pneumonia, Prediction value, Meta-analysis