{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:26:43Z","timestamp":1793410003299,"version":"4.5.0"},"reference-count":25,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2020,7,19]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chest computed tomography (CT) is commonly used to diagnose pneumonia in Japan, but its usability in terms of prognostic predictability is not obvious. We modified CURB-65 (confusion, urea &gt;7\u2005mmol\u00b7L<jats:sup>\u22121<\/jats:sup>, respiratory rate \u226530\u2005breaths\u00b7min<jats:sup>\u22121<\/jats:sup>, blood pressure &lt;90\u2005mmHg (systolic) \u226460\u2005mmHg (diastolic), age \u226565 years) and A-DROP scores with CT information and evaluated their ability to predict mortality in community-acquired pneumonia patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was conducted using a prospective registry of the Adult Pneumonia Study Group \u2013 Japan. Of the 791 registry patients, 265 hospitalised patients with chest CT were evaluated. Chest CT-modified CURB-65 scores were developed with the first 30 study patients. The 30-day mortality predictability of CT-modified, chest radiography-modified and original CURB-65 scores were validated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In score development, infiltrates over four lobes and pleural effusion on CT added extra points to CURB-65 scores. The area under the curve for CT-modified CURB-65 scores was significantly higher than that of chest radiography-modified or original CURB-65 scores (both p&lt;0.001). The optimal cut-off CT-modified CURB-65 score was \u22654 (positive-predictive value 80.8%; negative-predictive value 78.6%, for 30-day mortality). For sensitivity analyses, chest CT-modified A-DROP scores also demonstrated better prognostic value than did chest radiography-modified and original A-DROP scores. Poor physical status, chronic heart failure and multiple infiltration hampered chest radiography evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chest CT modification of CURB-65 or A-DROP scores improved the prognostic predictability relative to the unmodified scores. In particular, in patients with poor physical status or chronic heart failure, CT findings have a significant advantage. Therefore, CT can be used to enhance prognosis prediction.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00079-2020","type":"journal-article","created":{"date-parts":[[2020,11,23]],"date-time":"2020-11-23T13:53:47Z","timestamp":1606139627000},"page":"00079-2020","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic value of chest computed tomography in community-acquired pneumonia patients"],"prefix":"10.1183","volume":"6","author":[{"given":"Masahiro","family":"Nemoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Nakashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Noma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Matsue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Shiraishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Ishifuji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konosuke","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1468-5296","authenticated-orcid":false,"given":"Koya","family":"Ariyoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Aoshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,11,23]]},"reference":[{"key":"2024101708021103000_6.4.00079-2020.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32203-7"},{"key":"2024101708021103000_6.4.00079-2020.2","doi-asserted-by":"publisher","DOI":"10.1086\/511159"},{"key":"2024101708021103000_6.4.00079-2020.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03672.x"},{"key":"2024101708021103000_6.4.00079-2020.4","unstructured":"National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. Clinical guideline [CG191]. www.nice.org.uk\/guidance\/cg191. 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