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Copyright ©ERS Journals Ltd 2006
Validation of a predictive rule for the management of community-acquired pneumonia
1 Service of Pneumology, 2 Research Unit, and 3 Dept of Emergency Medicine, Hospital de Galdakao, Galdakao, and 4 The Basque Foundation for Health Innovation and Research (BIOEF), Sondika, Bizkaia, Spain.
CORRESPONDENCE: A. Capelastegui, Service of Pneumology, Hospital de Galdakao, E-48960 Galdakao, Bizkaia, Spain. Fax: 34 944572327. E-mail: acapelas{at}hgda.osakidetza.net
Keywords: Community-acquired pneumonia, prediction rule, severity assessment
Received: May 30, 2005
Accepted October 16, 2005
The CURB-65 score (Confusion, Urea >7 mmol·L–1, Respiratory rate
The six-point CURB-65 score was retrospectively applied in a prospective, consecutive cohort of adult patients with a diagnosis of CAP seen in the emergency department of a 400-bed teaching hospital from March 1, 2000 to February 29, 2004. A total of 1,100 inpatients and 676 outpatients were included.
The 30-day mortality rate in the entire cohort increased directly with increasing CURB-65 score: 0, 1.1, 7.6, 21, 41.9 and 60% for CURB-65 scores of 0, 1, 2, 3, 4, and 5, respectively. The score was also significantly associated with the need for mechanical ventilation and rate of hospital admission in the entire cohort, and with duration of hospital stay among inpatients.
The CURB-65 score (Confusion, Urea >7 mmol·L–1, Respiratory rate
30·min–1, low Blood pressure, and age 65 yrs) has been proposed as a tool for augmenting clinical judgement for stratifying patients with community-acquired pneumonia (CAP) into different management groups. 30·min–1, low Blood pressure, and age 65 yrs), and a simpler CRB-65 score that omits the blood urea measurement, helps classify patients with community-acquired pneumonia into different groups according to the mortality risk and significantly correlates with community-acquired pneumonia management key points. The new score can also be used as a severity adjustment measure.
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