CURB-65: Difference between revisions
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'''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> | ||
==CURB 65== | ==CURB 65== | ||
The score is an | The score is an acronym for each of the risk factors measured. Each risk factor scores one point, for a maximum score of 5: | ||
* '''C'''onfusion (defined as an [[abbreviated mental test score|AMT]] of 8 or less) | * '''C'''onfusion (defined as an [[abbreviated mental test score|AMT]] of 8 or less) | ||
* '''U'''rea greater than 7 mmol/l (Blood Urea Nitrogen > 20) | * '''U'''rea greater than 7 mmol/l (Blood Urea Nitrogen > 20) | ||
Revision as of 14:39, 5 November 2014
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CURB-65 On the Web |
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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
- ↑ 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.
- ↑ 2.0 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.
- ↑ 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.
- ↑ "BTS Guidelines for the Management of Community Acquired Pneumonia in Adults". Thorax. 56 Suppl 4: IV1–64. 2001. PMID 11713364.
- ↑ 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.
External Links
- British Thoracic Society
- ICU Medicus Pneumonia Severity Score - online calculator for the CURB-65