Comparison of CURB-65 and CRB-65 as predictors of death in community-acquired pneumonia in adults admitted to an ICU

Santana, AR; Amorim, FF; Soares, FB; Godoy, LG de Souza; Almeida, L de Jesus; Rodrigues, TA; Filho, GM de Andrade; Silva, Tarcı́lia Aparecida; Neto, OG da Silva; Rocha, Phg; Ferreira, P S B; Amorim, App; Moura, Edmilson Bastos de; Neto, JA Araújo; Maia, MO

doi:10.1186/cc12655

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…In another meta-analysis, Zaki HA et al obtained CURB-65 respect PSI was slightly better in early mortality prediction and in predicting admission to intensive care support [29]. Finally, in several clinical studies comparing CURB-65 to CRB-65, it emerges that: CRB-65 was more sensitive as a predictor of death as well as guidance for hospitalization, and it is a more practical score since it does not use laboratory variables [30,31,12].…”

Section: Discussionmentioning

confidence: 99%

SpO2/FiO2 ratio. A promising index in predicting mortality in COVID-19 patients

Zinna,

Pipitò,

Colomba

et al. 2023

Preprint

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Objectives: identifying high-risk COVID-19 patients is critical for emergency department decision-making. The primary objective of the study was to identify new independent predictors of mortality and their prognostic utility in combination with traditional pneumonia risk assessment scores. Methods: a retrospective study was performed in two Italian University Hospitals. A multivariable logistic model was used to locate independent parameters associated with mortality. Results: age, PaO2/FiO2 (P/F), and SpO2/FiO2 (S/F) ratios were found to be independent parameters associated with 30-day mortality. Study found that PSI was superior to CRB-65 and NEWS in predicting 30-day mortality (AUC: 0.766 vs. 0.763, p=0.981; AUC: 0.766 vs. 0.616, p=0.003). Combination of S/F with CRB-65 and NEWS improved the prognostic accuracy of score compared to “scoring without S/F” (p<0.001 vs. p<0.001 respectively) and compared to PSI (p=0.005 vs. p=0.483 respectively). Combination of P/F with CRB-65 and NEWS produced similar results. Conclusions: in our study, S/F was an independent parameter of 30-day mortality, and being a non-invasive parameter, it could be a valuable tool for staging COVID-19 patients upon admission to the hospital. The combination of S/F and CRB-65 performed similarly to the PSI, and can be a valid alternative to ferruginous PSI calculation and could provide valuable support for decision-makers.

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Section: Discussionmentioning

confidence: 99%

SpO2/FiO2 ratio. A promising index in predicting mortality in COVID-19 patients

Zinna,

Pipitò,

Colomba

et al. 2023

Preprint

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“…Furthermore, the associated cumulative AUC score [31] was introduced as a time-dependent measure to evaluate the risk of mortality for individual patients, computed backward in time from the day of discharge or death. The performance of our system was also compared with those of other standard models, such as the confusion, respiratory rate, blood pressure (qSOFA); confusion, urea nitrogen, respiratory rate, blood pressure, age ≥ 65 years (CURB 65); and confusion, respiratory rate, blood pressure, age ≥ 65 years (CRB 65) in both the development and validation cohorts [32] , [33] , [34] , [35] , [36] .…”

Section: Methodsmentioning

confidence: 99%

Development and Validation of a Prognostic Risk Score System for COVID-19 Inpatients: A Multi-Center Retrospective Study in China

et al. 2022

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Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. Hospitalized patients of COVID-19 suffer from a high mortality rate, motivating the development of convenient and practical methods that allow clinicians to promptly identify high-risk patients. Here, we have developed a risk score using clinical data from 1479 inpatients admitted to Tongji Hospital, Wuhan, China (development cohort) and externally validated with data from two other centers: 141 inpatients from Jinyintan Hospital, Wuhan, China (validation cohort 1) and 432 inpatients from The Third People’s Hospital of Shenzhen, Shenzhen, China (validation cohort 2). The risk score is based on three biomarkers that are readily available in routine blood samples and can easily be translated into a probability of death. The risk score can predict the mortality of individual patients more than 12 d in advance with more than 90% accuracy across all cohorts. Moreover, the Kaplan–Meier score shows that patients can be clearly differentiated upon admission as low, intermediate, or high risk, with an area under the curve (AUC) score of 0.9551. In summary, a simple risk score has been validated to predict death in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); it has also been validated in independent cohorts.

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“…CRB-65 has been shown to correlate highly with CURB-65 and is more convenient as it doesn't require blood work to be drawn. 10 In response to rising antimicrobial resistance, antimicrobial stewardship (AMS) initiatives have been implemented across the globe, driven by an ethical imperative to protect public health and improve patient care. 11 Accreditation Canada has also mandated AMS to be a component of all health care organizations that provide inpatient care and chronic, complex care.…”

Section: Introductionmentioning

confidence: 99%

Antibiotics Utilization for Community Acquired Pneumonia in a Community Hospital Emergency Department

Wang

Davidson

et al. 2020

Journal of Pharmacy Practice

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Background: A local health authority in Canada implemented its own Antimicrobial Stewardship Program (ASP) which provide guidelines to clinicians to utilize when treating infectious diseases such as community-acquired pneumonia (CAP). Objectives: The primary objective is to describe antibiotic usage patterns at the community hospital’s emergency department (ED) and to analyze the patterns in relation to ASP goals of reducing risk of infections, adverse drug events and antibiotic resistance, and to identify potential areas of improvement. Methods: This retrospective chart review included 156 adult patients with a diagnosis of CAP admitted to a community hospital ED from December 1, 2015 to November 30, 2016. Results: 50.6% patients were prescribed moxifloxacin across all severity of CAP patients. Low and moderate severity CAP patients were most often prescribed antibiotic duration > 7 days. In low, moderate and high severity CAP patients who were treated using ceftriaxone, 100%, 88.9% and 66.6% patients were treated with ceftriaxone 2000 mg daily respectively. Conclusions: Antibiotic prescribing patterns suggest fluoroquinolones were frequently being over-prescribed, ceftriaxone dosages were often too high, and duration of antibiotics for low and moderate severity CAP were too long. More efforts are needed to promote appropriate antibiotic usage and optimize patient care.

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Comparison of CURB-65 and CRB-65 as predictors of death in community-acquired pneumonia in adults admitted to an ICU

Cited by 3 publications

References 2 publications

SpO2/FiO2 ratio. A promising index in predicting mortality in COVID-19 patients

SpO2/FiO2 ratio. A promising index in predicting mortality in COVID-19 patients

Development and Validation of a Prognostic Risk Score System for COVID-19 Inpatients: A Multi-Center Retrospective Study in China

Antibiotics Utilization for Community Acquired Pneumonia in a Community Hospital Emergency Department

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