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6%) died by day 30, 91 patients (8.4%) had a need for mechanical ventilation or vasopressor support (MV/VS) and 99 patients (9.2%) developed a complicated pneumonia. There were 37 deaths in patients requiring MV/VS during the study (40.7% of those requiring MV/VS). The mortality rate in patients with complicated pneumonia was 9.1%. The median length of stay was 5?days (IQR 3�C11). Characteristics of the study population are shown in Table?1. [http://en.wikipedia.org/wiki/Fluconazole Fluconazole] The median time taken to achieve clinical stability for each criterion stratified by the Pneumonia Severity Index (PSI) and CURB-65 class on admission are shown in Tables?2 and 3. The median time to clinical stability was 3?days for all criteria (Table?2 and 3). Patients with more severe pneumonia on admission assessed by both CURB-65 and PSI took a significantly longer time to reach clinical stability. This association was true for all the methods available to assess clinical stability (p?[http://www.selleckchem.com/products/bgj398-nvp-bgj398.html selleck] optimal at different time-points; C-reactive protein was of limited value before day 3 but improved its discriminatory ability from day 3 onwards. The CURB criteria had the highest Youden index on admission for both 30-day mortality and MV/VS but were lower at later time-points, consistent with this being an admission severity score. Halm's criteria and the ATS criteria were consistently higher than CURB for the majority of outcomes (see Fig.?1). The area under the receiver operator characteristic curve was used to compare [http://www.selleckchem.com/products/Paclitaxel(Taxol).html Paclitaxel datasheet] predictive indices across the first 7?days of hospitalization (Table?5). During this time, Halm's criteria had the highest area under the curve for prediction of 30-day mortality, need for mechanical ventilation and combined adverse outcomes. C-reactive protein had the highest area under the curve for complicated pneumonia. Adding C-reactive protein to Halm's criteria increased the area under the curve, but the difference was only statistically significant for complicated pneumonia. Adding CRP to the ATS criteria did not significantly increase the AUC, except for prediction of complicated pneumonia. Although the difference was small, Halm's criteria had a significantly higher area under the receiver operator characteristic curve compared with the ATS criteria, CURB and C-reactive protein for the combined outcome. Clinical stability has emerged as a key concept in community-acquired pneumonia management [7-9].