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{{Pneumonia}}
{{Pneumonia}}
{{CMG}}; ; Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh@perfuse.org]
{{CMG}}; ; Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]
==Overview==
==Overview==
'''CURB-65''' is a [[clinical prediction rule]] that has been validated for predicting mortality in [[community-acquired pneumonia]]<ref name="pmid12728155">{{cite journal |author=Lim WS, van der Eerden MM, Laing R, ''et al'' |title=Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study |journal=Thorax |volume=58 |issue=5 |pages=377-82 |year=2003 |pmid=12728155 |doi=}}</ref> and infection of any site<ref name="pmid17576773">{{cite journal |author=Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI |title=Performance of severity of illness scoring systems in emergency department patients with infection |journal=Academic emergency medicine : official journal of the Society for Academic Emergency Medicine |volume=14 |issue=8 |pages=709-14 |year=2007 |pmid=17576773 |doi=10.1197/j.aem.2007.02.036}}</ref>. The CURB-65 is based on the earlier CURB score<ref name="pmid11254821">{{cite journal |author=Lim WS, Macfarlane JT, Boswell TC, ''et al'' |title=Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines |journal=Thorax |volume=56 |issue=4 |pages=296-301 |year=2001 |pmid=11254821 |doi=}}</ref> and is recommended by the [[British Thoracic Society]] for the assessment of severity of pneumonia.<ref name="pmid11713364">{{cite journal |author= |title=BTS Guidelines for the Management of Community Acquired Pneumonia in Adults |journal=Thorax |volume=56 Suppl 4 |issue= |pages=IV1-64 |year=2001 |pmid=11713364 |doi=}}</ref>
'''CURB-65''' is a [[clinical prediction rule]] that has been validated for predicting mortality in [[community-acquired pneumonia]]<ref name="pmid12728155">{{cite journal |author=Lim WS, van der Eerden MM, Laing R, ''et al'' |title=Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study |journal=Thorax |volume=58 |issue=5 |pages=377-82 |year=2003 |pmid=12728155 |doi=}}</ref> and infection of any site<ref name="pmid17576773">{{cite journal |author=Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI |title=Performance of severity of illness scoring systems in emergency department patients with infection |journal=Academic emergency medicine : official journal of the Society for Academic Emergency Medicine |volume=14 |issue=8 |pages=709-14 |year=2007 |pmid=17576773 |doi=10.1197/j.aem.2007.02.036}}</ref>. The CURB-65 is based on the earlier CURB score<ref name="pmid11254821">{{cite journal |author=Lim WS, Macfarlane JT, Boswell TC, ''et al'' |title=Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines |journal=Thorax |volume=56 |issue=4 |pages=296-301 |year=2001 |pmid=11254821 |doi=}}</ref> and is recommended by the [[British Thoracic Society]] for the assessment of severity of pneumonia.<ref name="pmid11713364">{{cite journal |author= |title=BTS Guidelines for the Management of Community Acquired Pneumonia in Adults |journal=Thorax |volume=56 Suppl 4 |issue= |pages=IV1-64 |year=2001 |pmid=11713364 |doi=}}</ref>

Revision as of 01:07, 2 November 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; ; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]

Overview

CURB-65 is a clinical prediction rule that has been validated for predicting mortality in community-acquired pneumonia[1] and infection of any site[2]. The CURB-65 is based on the earlier CURB score[3] and is recommended by the British Thoracic Society for the assessment of severity of pneumonia.[4]

CURB 65

The score is an acronym for each of the risk factors measured. Each risk factor scores one point, for a maximum score of 5:

  • confusion (defined as an AMT of 8 or less)
  • urea greater than 7 mmol/l (Blood Urea Nitrogen > 20)
  • respiratory rate of 30 breaths per minute or greater
  • blood pressure less than 90 systolic or diastolic blood pressure 60 or less
  • age 65 or older

Predicting death from pneumonia

The risk of death increases as the score increases:

  • 0—0.7%
  • 1—3.2%
  • 2—13.0%
  • 3—17.0%
  • 4—41.5%
  • 5—57.0%

The CURB-65 has been compared to the pneumonia severity index in predicting mortality from pneumonia.[5]

Predicting death from any infection

A cohort study of patients with any type of infection (half of the patients had pneumonia), the risk of death increases as the score increases[2]:

  • 0 to 1 <5% mortality
  • 2 to 3 < 10% mortality
  • 4 to 5 15-30% mortality

References

  1. Lim WS, van der Eerden MM, Laing R; et al. (2003). "Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study". Thorax. 58 (5): 377–82. PMID 12728155.
  2. 2.0 2.1 Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI (2007). "Performance of severity of illness scoring systems in emergency department patients with infection". Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 14 (8): 709–14. doi:10.1197/j.aem.2007.02.036. PMID 17576773.
  3. Lim WS, Macfarlane JT, Boswell TC; et al. (2001). "Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines". Thorax. 56 (4): 296–301. PMID 11254821.
  4. "BTS Guidelines for the Management of Community Acquired Pneumonia in Adults". Thorax. 56 Suppl 4: IV1–64. 2001. PMID 11713364.
  5. Aujesky D, Auble TE, Yealy DM; et al. (2005). "Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia". Am. J. Med. 118 (4): 384–92. doi:10.1016/j.amjmed.2005.01.006. PMID 15808136.

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