Background: Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality. Accurate prediction of mortality is crucial for guiding clinical decisions and optimizing patient outcomes. The Pneumonia Severity Index (PSI) and CURB-65 scores are commonly used scoring systems for mortality prediction in CAP. This study aimed to compare the predictive accuracy of the PSI and CURB-65 scores in hospitalised patients with CAP.

Methods: A prospective observational study was conducted in the General Medicine Department of a tertiary care hospital. A total of 100 patients diagnosed with CAP were included. Demographic and clinical data were collected upon admission, and the PSI and CURB-65 scores were calculated. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive accuracy of both scores.

Results: The in-hospital mortality rate was 23% for patients with CAP. The PSI score exhibited an area under the ROC curve of 0.88, indicating a high level of accuracy in predicting mortality. The CURB-65 score demonstrated an AUC of 0.81, suggesting moderate accuracy. Comparison with existing literature showed consistent findings regarding the PSI score's superior performance.

Conclusion: Both the PSI and CURB-65 scores have value in predicting mortality in hospitalised patients with CAP. However, the PSI score demonstrated slightly higher discriminatory power. These scoring systems, along with clinical judgment and additional diagnostic tests, can aid in risk stratification and guide decision-making. Further multicenter studies with larger sample sizes are needed to validate these findings and explore other scoring systems for improved risk stratification in CAP.