The usefulness of confusion, urea, respiratory rate, and shock index or adjusted shock index criteria in predicting combined mortality and/or ICU admission compared to CURB-65 in community-acquired pneumonia

Biomed Res Int. 2013:2013:590407. doi: 10.1155/2013/590407. Epub 2013 Aug 20.

Abstract

Background and objectives: The study aims to assess the usefulness of age-independent criteria CURSI and temperature adjusted CURSI (CURASI) compared to CURB-65 in predicting community-acquired pneumonia (CAP) mortality. The criteria, CRSI and CRASI, were adapted for use in primary care and compared to CRB-65.

Methods: A retrospective analysis of a prospectively identified cohort of community-acquired pneumonia inpatients was conducted. Outcomes were (1) mortality and (2) mortality and/or ICU admission within six weeks.

Results: 95 patients (median age = 61 years) were included. All three criteria had similar sensitivity in predicting mortality alone, with CURB-65 having slightly higher specificity. When predicting mortality and/or intensive care admission, CURSI/CURASI showed higher sensitivity and slightly lower specificity. CRSI and CRASI had higher sensitivity and lower specificity when compared with CRB-65 for predicting both primary and secondary outcomes. Results for both analyses had P values >0.05.

Conclusions: In a cohort of younger patients CURSI and adjusted CURSI perform at least as well as CURB-65, with a similar trend for CRSI and adjusted CRSI compared to CRB-65. Further studies are needed in different age groups and in primary and secondary care settings.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Community-Acquired Infections / mortality*
  • Confusion / diagnosis
  • Confusion / pathology*
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pneumonia / mortality*
  • Respiratory Rate*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Urea / metabolism

Substances

  • Urea