Comparison of CURB-65 and CRB-65 as predictors of death in community-acquired pneumonia in adults admitted to an ICU
© Santana et al; licensee BioMed Central Ltd. 2013
Published: 19 June 2013
Community-acquired pneumonia is one of the most common causes of sepsis and ICU admissions. Patients with CAP who demand critical care had mortality rates of 25 to 50%. Thereby, the assessment of the severity is essential to guide the treatment. There are several severity scores for CAP and some of the most acknowledged are CURB-65 and CRB-65. The objective of this study was to evaluate the accuracy of CURB-65 and CRB-65 as predictors of death in patients with community-acquired pneumonia.
A prospective study during 6 months was conducted with patients diagnosed with CAP admitted to the ICU of the Hospital Santa Luzia, Brasília, DF, Brazil. Patients were stratified according to CURB-65 (0 to 5) and CRB-65 (0 to 4) and their risk categorized as: low (CURB-65: 0 to 1 and CRB-65: 0), moderate (CURB-65: 2 and CRB-65: 1 to 2) and high (CURB-65: 3 to 5 and CRB-65: 3 to 4). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio positive (LR+), and likelihood ratio negative (LR-) were calculated. Validity and reliability were assessed with the Spearman correlation coefficient. Patients with chronic kidney failure and those submitted to mechanical ventilation at the time of admission were excluded.
CURB-65 and CRB-65 had a high correlation. CRB-65 was more sensitive as a predictor of death as well as a guidance for hospitalization. Moreover, CRB-65 is a more practical score since it does not use laboratorial variables.
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