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

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 retr...

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Bibliographic Details
Published in:BioMed research international 2013-01, Vol.2013 (2013), p.1-6
Main Authors: Myint, Phyo K., Kamath, Ajay V., Sankaran, Prasanna, Curtain, James P.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Aged
Aged, 80 and over
Bacterial pneumonia
Clinical Study
Community-Acquired Infections - mortality
Confusion - diagnosis
Confusion - pathology
Diagnosis
Female
Humans
Intensive Care Units
Male
Middle Aged
Mortality
Patient outcomes
Pneumonia
Pneumonia - mortality
Respiratory Rate
Retrospective Studies
Risk factors
Sensitivity and Specificity
United Kingdom
Urea - metabolism
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Summary: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.
ISSN:2314-6133
2314-6141
DOI:10.1155/2013/590407