PREDICTIVE VALUE OF CURB-65 AND QSOFA SCORES FOR MORTALITY RISK: IMPLICATIONS FOR PHYSICAL RECOVERY AND REHABILITATION IN PATIENTS WITH PNEUMOCYSTIS CARINII PNEUMONIA AND IMMUNODEFICIENCY

Abstract

Purpose: This study aims to assess the clinical predictive value of the CURB-65 and qSOFA scores for mortality risk in patients with acquired immunodeficiency syndrome (AIDS) and Pneumocystis Carinii Pneumonia (PCP), with an emphasis on the implications for physical recovery, rehabilitation, and overall functional outcomes. The study also compares the predictive efficacy of these scores and evaluates the role of additional biomarkers in improving prognostic accuracy. Methods: A total of 120 patients with AIDS and PCP admitted to Beijing Youan Hospital, affiliated with Capital Medical University, from January to December 2022, were included. Patients were categorized into survival (n=85) and death (n=35) groups based on prognosis. Clinical data collected included demographics, hospitalization duration, tracheal intubation status, mechanical ventilation duration, CD4+ T lymphocyte count, WBC, CRP, PCT, GCS score, and HRCT findings. CURB-65, qSOFA, and HRCT scores were calculated, and logistic regression analysis identified independent risk factors for mortality. Receiver operating characteristic (ROC) curve analysis evaluated the predictive accuracy of individual and combined indicators. Results: The death group exhibited higher rates of tracheal intubation, mechanical ventilation duration, WBC, CRP, PCT, CURB-65, qSOFA, and HRCT scores, with lower CD4+ T lymphocyte counts (P < 0.05). WBC, CURB-65 score, qSOFA score, and HRCT score were identified as independent predictors of mortality risk (P < 0.05). Predictive performance was higher for the CURB-65 score (AUC 0.913, P < 0.001) than for the qSOFA score (AUC 0.850, P < 0.001). Combined indicators (CURB-65 + HRCT + WBC) further improved predictive accuracy (AUC 0.958, P < 0.001) compared to qSOFA + HRCT + WBC (AUC 0.926, P < 0.001). Conclusions: The CURB-65 score, qSOFA score, and associated biomarkers (WBC and HRCT) provide significant predictive value for mortality risk in AIDS patients with PCP. The CURB-65 score demonstrated superior individual predictive performance, while CURB-65 + HRCT + WBC offered the highest accuracy in combined assessments. These findings underscore the potential for leveraging these prognostic tools to design targeted rehabilitation strategies and optimize recovery outcomes, particularly for patients aiming to regain physical functionality and engage in rehabilitation programs. Further research is recommended to integrate these tools into multidisciplinary care models that prioritize both survival and functional recovery.