|
|
| (14 intermediate revisions by 6 users not shown) |
| Line 1: |
Line 1: |
| {{SI}}
| | #Redirect[[Community-acquired pneumonia severity criteria#CURB-65 Clinical Prediction Rule]] |
| {{EH}}
| |
| | |
| '''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>
| |
| | |
| The score is an [[Wiktionary:acronym|acronym]] for each of the risk factors measured. Each risk factor scores one point, for a maximum score of 5:
| |
| * confusion (defined as an [[abbreviated mental test score|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.<ref name="pmid15808136">{{cite journal |author=Aujesky D, Auble TE, Yealy DM, ''et al'' |title=Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia |journal=Am. J. Med. |volume=118 |issue=4 |pages=384-92 |year=2005 |pmid=15808136 |doi=10.1016/j.amjmed.2005.01.006}}</ref>
| |
| | |
| ==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<ref name="pmid17576773"/>:
| |
| * 0 to 1 <5% mortality
| |
| * 2 to 3 < 10% mortality
| |
| * 4 to 5 15-30% mortality
| |
| | |
| ==References==
| |
| <references/>
| |
| | |
| ==External links==
| |
| *[http://www.brit-thoracic.org.uk British Thoracic Society]
| |
| *[http://www.icumedicus.com/clinical_criteria/pneumonia_severity_score.php ICU Medicus Pneumonia Severity Score] - online calculator for the CURB-65
| |
| | |
| {{SIB}}
| |
| | |
| [[Category:Pulmonology]]
| |
| [[Category:Medical signs]]
| |
| [[Category:Drugs]]
| |
| | |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |