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. 2016 Mar 18:6:22911.
doi: 10.1038/srep22911.

Expanded CURB-65: a new score system predicts severity of community-acquired pneumonia with superior efficiency

Jin-liang Liu  1 , Feng Xu  1 , Hui Zhou  1   2 , Xue-jie Wu  1 , Ling-xian Shi  1 , Rui-qing Lu  1 , Alessio Farcomeni  3 , Mario Venditti  3 , Ying-li Zhao  1 , Shu-ya Luo  1 , Xiao-jun Dong  1 , Marco Falcone  3
Affiliations

Expanded CURB-65: a new score system predicts severity of community-acquired pneumonia with superior efficiency

Jin-liang Liu et al. Sci Rep. .

Erratum in

Abstract

Aim of this study was to develop a new simpler and more effective severity score for community-acquired pneumonia (CAP) patients. A total of 1640 consecutive hospitalized CAP patients in Second Affiliated Hospital of Zhejiang University were included. The effectiveness of different pneumonia severity scores to predict mortality was compared, and the performance of the new score was validated on an external cohort of 1164 patients with pneumonia admitted to a teaching hospital in Italy. Using age ≥ 65 years, LDH > 230 u/L, albumin < 3.5 g/dL, platelet count < 100 × 10(9)/L, confusion, urea > 7 mmol/L, respiratory rate ≥ 30/min, low blood pressure, we assembled a new severity score named as expanded-CURB-65. The 30-day mortality and length of stay were increased along with increased risk score. The AUCs in the prediction of 30-day mortality in the main cohort were 0.826 (95% CI, 0.807-0.844), 0.801 (95% CI, 0.781-0.820), 0.756 (95% CI, 0.735-0.777), 0.793 (95% CI, 0.773-0.813) and 0.759 (95% CI, 0.737-0.779) for the expanded-CURB-65, PSI, CURB-65, SMART-COP and A-DROP, respectively. The performance of this bedside score was confirmed in CAP patients of the validation cohort although calibration was not successful in patients with health care-associated pneumonia (HCAP). The expanded CURB-65 is objective, simpler and more accurate scoring system for evaluation of CAP severity, and the predictive efficiency was better than other score systems.

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Figures

Figure 1
Figure 1. ROC curves for five scoring systems in the main cohort of CAP patients.
Figure 2
Figure 2. ROC curves for five scoring systems in CAP and HACP patients in the validation cohort.
See this image and copyright information in PMC

References

    1. Restrepo M. I., Mortensen E. M., Velez J. A., Frei C. & Anzueto A. A comparative study of community-acquired pneumonia patients admitted to the ward and the ICU. Chest. 133, 610–7 (2008). - PubMed
    1. Renaud B. et al.. Association between timing of intensive care unit admission and outcomes for emergency department patients with community-acquired pneumonia. Crit Care Med. 37, 2867–74 (2009). - PubMed
    1. Venditti M. et al.. Comparison of the outcomes of patients hospitalized with community-acquired, health care–associated, and hospital-acquired pneumonia. Ann Intern Med. 150, 19–26 (2009). - PubMed
    1. Falcone M., Shindo Y., Venditti M. & Kollef M. H. Healthcare-associated pneumonia: diagnostic criteria and distinction from community-acquired pneumonia. Int J Infect Dis. 15, e545–50 (2011). - PubMed
    1. Fine M. J. et al.. A prediction rule to identify low risk patients with community-acquired pneumonia. N Engl J Med. 336, 243–50 (1997). - PubMed

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