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CRB‐65 predicts death from community‐acquired pneumonia *
Author(s) -
BAUER T. T.,
EWIG S.,
MARRE R.,
SUTTORP N.,
WELTE T.
Publication year - 2006
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2006.01657.x
Subject(s) - medicine , pneumonia , community acquired pneumonia , intensive care medicine
. Objective. The study was performed to validate the CURB, CRB and CRB‐65 scores for the prediction of death from community‐acquired pneumonia (CAP) in both the hospital and out‐patient setting. Design. Data were derived from a large multi‐centre prospective study initiated by the German competence network for community‐acquired pneumonia (CAPNETZ) which started in March 2003 and were censored for this analysis in October 2004. Setting. Out‐ and in‐hospital patients in 670 private practices and 10 clinical centres. Subjects. Analysis was done for n = 1343 patients ( n = 208 out‐patients and n = 1135 hospitalized) with all data sets completed for the calculation of CURB and repeated for n = 1967 patients ( n = 482 out‐patients and n = 1485 hospitalized) with complete data sets for CRB and CRB‐65. Intervention. None. 30‐day mortality from CAP was determined by personal contacts or a structured interview. Results. Overall 30‐day mortality was 4.3% (0.6% in out‐patients and 5.5% in hospitalized patients, P < 0.0001). Overall, the CURB, CRB and CRB‐65 scores provided comparable predictions for death from CAP as determined by receiver–operator‐characteristics (ROC) curves. However, in hospitalized patients, CRB misclassified 26% of deaths as low risk patients. Availability of the CRB‐65 score (90%) was far superior to that of CURB (65%), due to missing blood urea nitrogen values ( P < 0.001). Conclusions. Both the CURB and CRB‐65 scores can be used in the hospital and out‐patients setting to assess pneumonia severity and the risk of death. Given that the CRB‐65 is easier to handle, we favour the use of CRB‐65 where blood urea nitrogen is unavailable.