Predicting Disease Severity and Mortality in Patients with COVID-19 Pneumonia: the Role of Integrated Pulmonary Index

EUSEM 2026 European Cogress On Emergency Medicine, Paris, Fransa, 23 - 27 Eylül 2026, ss.1-2, (Özet Bildiri)

Background: To overcome the triage challenges faced by emergency department (ED)s during the pandemic,

rapid tools are needed to identify patients at risk of critical illness. We aimed to investigate the clinical value of

the integrated pulmonary index (IPI) in predicting disease severity and mortality in patients with COVID-19

pneumonia.

Material and methods: This prospective observational study included 228 adult patients with suspected or

confirmed COVID-19 pneumonia admitted to two hospital EDs between June 15 and September 15, 2021.

Patient vitals, continuous five-minute IPI measurements, laboratory, and radiological findings were recorded. The

prognostic performance of the IPI for hospital admission, intensive care unit admission, and mortality was

compared against established early warning scores including the national early warning score 2 (NEWS2),

modified early warning score (MEWS), quick sequential organ failure assessment (qSOFA), targeted real-time

early warning score (TREWS), COVID-19 severity index (CSI), and pneumonia severity index (PSI).

Results: Moderate-to-severe pneumonia required hospital admission in 192 cases, and 50 patients developed

critical illness. For predicting hospital admission, the mean IPI and five-minute IPI showed better performance

than traditional scoring systems including NEWS2, MEWS, and qSOFA with AUC of 0.905, 0.903, 0.901, 0.766,

and 0.705, respectively. Using a cut-off value of 7 for the five-minute IPI yielded a positive predictive value

greater than 97% for hospital admission. For mortality prediction, the five-minute IPI (0.831) and initial IPI (0.826)

demonstrated high efficacy, performing closely to complex scoring systems like CSI (0.844) and PSI (0.840). An

IPI threshold of 3 or less was found to be a strong predictor of mortality.

Conclusions: The IPI is a highly accurate, rapid, and practical monitoring tool in the ED for risk-stratifying

patients with COVID-19 pneumonia. It performs comparably or superiorly to complex, multiparametric clinical

scoring systems in predicting hospital admission and mortality, thereby assisting clinicians in rapid

decision-making.