CURB-65 score predicted mortality in community-acquired pneumonia better than IDSA/ATS minor criteria in a low-mortality-rate setting
- 495 Downloads
The CURB-65 scoring system performs well at identifying patients with pneumonia who have a low risk of death. Whether it predicts mortality in community-acquired pneumonia (CAP) better than the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria in low-mortality-rate settings is not clear. The purpose of this study was to determine the hypothesis.A total of 1,230 adult inpatients admitted to our hospital from 2005 to 2009 for CAP were reviewed retrospectively.The hospital mortality was 1.3 %. Percentage mortality increased significantly with CURB-65 score and the increasing number of IDSA/ATS minor criteria present. The number of CURB-65 criteria or IDSA/ATS minor criteria present had significant increased odds ratios for mortality of 7.547 and 2.711, respectively. The sensitivities of a CURB-65 score of ≥3 and the presence of ≥3 minor criteria in predicting mortality was 25 % and 37.5 %, which increased to 75 % and 62.5 %, while the cut-off values reduced to ≥2 criteria, respectively. The area under the receiver operating characteristic curve for CURB-65 was greater than the corresponding area for IDSA/ATS minor criteria in predicting hospital mortality (0.915 vs. 0.805, p = 0.0091).CURB-65 score predicted hospital mortality better than IDSA/ATS minor criteria, and a CURB-65 score of ≥2 or the presence of ≥2 minor criteria might be more valuable cut-off values for “severe” CAP in a low-mortality-rate setting.
We are indebted to the nurses, further education physicians, and postgraduates of the Department of Respiratory Medicine, and the staff of the Department of Medical Record for making contributions to this study.
Conflict of interest
The authors declare that they have no conflict of interest.
The study was funded by the medical science and technology foundation of Guangdong province in 2010 (No. A2010553), the planned science and technology project of Shenzhen municipality in 2011 (No. 201102078), and the non-profit scientific research project of Futian district in 2011 (No. FTWS201120).
Q.G, H-Y.L, and Y-P.Z made substantial contributions to conception and design. Q.G and H-Y.L were in charge of data collection and wrote the manuscript. L-H.L, Q-Z.Z, Y-P.Z, and M.L read the chest radiographs and CT scans. X-K.C, H.L, H-L.P, H-Q.Y, X.C, and N.L made substantial contributions to acquisition of data. M.J was in charge of statistical analysis.
- 4.British Thoracic Society Standards of Care Committee (2001) BTS guidelines for the management of community acquired pneumonia in adults. Thorax 56(Suppl 4):IV1–IV64Google Scholar