CRB‐65 predicts death from community‐acquired pneumonia*

Bauer, Torsten T.; Ewig, Santiago; Marre, R.; Suttorp, Norbert; Welte, Tobias

doi:10.1111/j.1365-2796.2006.01657.x

Cited by 264 publications

(203 citation statements)

References 19 publications

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“…Blood urea is replaced by age o65 yrs. A recent analysis of the CAPNETZ study group [11] validated the CURB, CRB and CRB-65 scores for the prediction of death from CAP in the hospital and outpatient setting. Analysis was performed for 1,343 CAP patients and overall 30-day mortality was 4.3% (0.6% in outpatients and 5.5% in hospitalised patients).…”

Section: Discussionmentioning

confidence: 99%

“…Prognostic scores for CAP have been developed to assess pneumonia severity in order to validate clinical judgement and to guide decisions about treatment settings [3][4][5][6][7][8][9][10]. In Europe, the CURB (confusion, urea .7 mmol?L -1 , respiratory rate o30 breaths?min -1 , low blood pressure (systolic value ,90 mmHg or diastolic value f60 mmHg) and age o65 yrs) score or the CRB-65 (confusion, respiratory rate o30 breaths?min -1 , low blood pressure (systolic value ,90 mmHg or diastolic value f60 mmHg) and age o65 yrs) score are currently advocated as preferred scores due to their simplicity and applicability in the ambulatory setting [7,11].…”

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confidence: 99%

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Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes

Krüger¹,

Ewig²,

Marre³

et al. 2008

European Respiratory Journal

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258

177

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on behalf of the CAPNETZ Study Group ABSTRACT: The aim of the present study was to investigate the prognostic value, in patients with community-acquired pneumonia (CAP), of procalcitonin (PCT) compared with the established inflammatory markers C-reactive protein (CRP) and leukocyte (WBC) count alone or in combination with the CRB-65 (confusion, respiratory rate o30 breaths?min -1 , low blood pressure (systolic value ,90 mmHg or diastolic value f60 mmHg) and age o65 yrs) score. In total, 1,671 patients with proven CAP were enrolled in the study. PCT, CRP, WBC and CRB-65 score were all determined on admission and patients were followed-up for 28 days for survival.In contrast to CRP and WBC, PCT levels markedly increased with the severity of CAP, as measured by the CRB-65 score. In 70 patients who died during follow-up, PCT levels on admission were significantly higher compared with levels in survivors. In receiver operating characteristic analysis for survival, the area under the curve (95% confidence interval) for PCT and CRB-65 was comparable (0.80 (0.75-0.84) versus 0.79 (0.74-0.84)), but each significantly higher compared with CRP (0.62 (0.54-0.68)) and WBC (0.61 (0.54-0.68)). PCT identified low-risk patients across CRB classes 0-4.In conclusion, procalcitonin levels on admission predict the severity and outcome of community-acquired pneumonia with a similar prognostic accuracy as the CRB-65 score and a higher prognostic accuracy compared with C-reactive protein and leukocyte count. Procalcitonin levels can provide independent identification of patients at low risk of death within CRB-65 (confusion, respiratory rate o30 breaths?min -1 , low blood pressure (systolic value ,90 mmHg or diastolic value f60 mmHg) and age o65 yrs) risk classes.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes

Krüger¹,

Ewig²,

Marre³

et al. 2008

European Respiratory Journal

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258

177

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“…Los cuatros índices pronósticos permitieron identificar a los pacientes con alto riesgo de muerte en el seguimiento a 30 días [18][19][20][21]23 . Sin embargo, el índice de Fine y SCAP fueron más precisos y específicos y el SMART-COP fue más sensible para predecir el riesgo de muerte comparado con el CURB-65 y CRB-65.…”

Section: Discussionunclassified

“…Además, se calculó la variante CRB-65, que a diferencia del CURB-65, no requiere exámenes de laboratorio y puede ser utilizada por los médicos en el ámbito ambulatorio 23 . El compromiso cualitativo de conciencia o confusión mental fue definido por la presencia de desorientación en tiempo, espacio y/o personas que no corresponden a una condición basal conocida o coma.…”

Section: Pacientes Y Métodounclassified

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Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad

et al. 2017

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Predicting Death in Elderly Patients With Community-Acquired Pneumonia: A Prospective Validation Study Reevaluating the CRB-65 Severity Assessment Tool

Bont¹,

Hak

Hoes³

et al. 2008

Arch Intern Med

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S everity scores are helpful in predicting mortality in patients presenting with communityacquired pneumonia (CAP). They enable physicians to decide their management strategies and site of care according to the expected mortality risk. In Europe, most cases of lower respiratory tract infections (LRTIs) and CAP are managed in primary care settings by general practitioners (GPs). However, most severity scores have been derived and validated in a hospital setting. The best accepted tools to discriminate patients with CAP into high or low risk are the CURB-65 score (confusion, serum urea nitrogen level Ͼ19.6 mg/dL [to convert to millimoles per liter, multiply by 0.357], respiratory rate Ն30/min, low blood pressure, and age Ն65 years) and the Pneumonia Severity Index (PSI). 1,2 The CURB-65 score consists of 5 easily accessible data, while the PSI includes many tests that are not accessible in primary care. This latter score is therefore not useful for the GP. Recently, several studies evaluated the CURB-65 score and confirmed its validity, but validation was not yet done in an unselected primary care population. 3-9 A modification of the CURB-65 score, the CRB-65 score, is recommended by GPs in the communities where serum urea nitrogen measurements are often unavailable. It is expected to support GP judgment in stratifying patients into different management groups, ranging from home treatment to urgent hospital admission (Figure). 1 This management model seems unlikely to be practical in a primary care population because it recommends hospital referral for a score of 1 or higher and thus for all patients older than 65 years (Figure). We therefore conducted a study to evaluate the validity of the CRB-65 score in primary care. Methods. Study Population. Between November 2005 and May 2006, Dutch GPs prospectively included patients with CAP who were 65 years or older. Community-acquired pneumonia was diagnosed on the basis of the presence of 1 or more features, including new localizing signs present during chest examination, new infiltrates on a

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CRB‐65 predicts death from community‐acquired pneumonia*

Abstract: Abstract. Bauer TT, Ewig S, Marre R, Suttorp N,

Cited by 264 publications

References 19 publications

Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes

Procalcitonin predicts patients at low risk of death from community-acquired pneumonia across all CRB-65 classes

Evaluación de los índices predictores de eventos adversos en el adulto inmunocompetente hospitalizado por neumonía adquirida en la comunidad

Predicting Death in Elderly Patients With Community-Acquired Pneumonia: A Prospective Validation Study Reevaluating the CRB-65 Severity Assessment Tool

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