Enhancement of CURB65 score with proadrenomedullin (CURB65-A) for outcome prediction in lower respiratory tract infections: Derivation of a clinical algorithm
2011

Improving Prediction of Outcomes in Lung Infections with CURB65-A Score

Sample size: 1359 publication Evidence: moderate

Author Information

Author(s): Albrich Werner C, Dusemund Frank, Rüegger Kristina, Christ-Crain Mirjam, Zimmerli Werner, Bregenzer Thomas, Irani Sarosh, Buergi Ulrich, Reutlinger Barbara, Mueller Beat, Schuetz Philipp

Primary Institution: Medical University Department of the University of Basel, Kantonsspital Aarau, Switzerland

Hypothesis

Combining the CURB65 score with Proadrenomedullin levels will enhance outcome prediction in patients with lower respiratory tract infections.

Conclusion

The CURB65-A risk score effectively predicts adverse events and mortality in patients with community-acquired pneumonia and other lower respiratory tract infections.

Supporting Evidence

  • The CURB65-A score provided better prediction of death and adverse events than the CURB65 score.
  • Patients with CURB65 score 0-1 and ProADM ≤0.75 nmol/l had a low risk of adverse events (3.9%) and mortality (0.65%).
  • 40.8% of hospitalized patients could have received a short hospitalization based on the CURB65-A score.

Takeaway

Doctors can better decide how to treat patients with lung infections by using a new score that combines two tests.

Methodology

Data from 1359 patients with lower respiratory tract infections were analyzed to create a new risk score combining CURB65 and Proadrenomedullin levels.

Potential Biases

Potential bias may arise from the subjective nature of clinical decision-making regarding ICU admissions.

Limitations

The study primarily focused on patients with community-acquired pneumonia, which may limit the applicability of the CURB65-A score to other types of lower respiratory tract infections.

Participant Demographics

58% males, median age 73 years, with over 70% having at least one comorbidity.

Statistical Information

P-Value

p<0.0001

Confidence Interval

95%CI: 0.77-0.86

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2334-11-112

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