CRB-65 predicts death from community-acquired pneumonia
CRB-65 predicts death from community-acquired pneumonia
复制标题
DOI：
10.1111/j.1365-2796.2006.01657.x
复制
发表时间：
2006-07-01
影响因子：
11.1
通讯作者：
Welte, T.
中科院分区：
文献类型：
--
作者：
Bauer, T. T.;Ewig, S.;Welte, T.
Objective.该研究旨在验证CURB、CRB和CRB-65评分对医院和门诊社区获得性肺炎（CAP）死亡的预测作用。数据来源于德国社区获得性肺炎能力网络（CAPNETZ）发起的一项大型多中心前瞻性研究，该研究于2003年3月开始，并于2004年10月进行删失。670家私人诊所和10家临床中心的门诊和住院患者。对n = 1343例患者（n = 208例门诊患者和n = 1135例住院患者）进行了分析，所有数据集均已完成CURB计算，并对n = 1967例患者（n = 482例门诊患者和n = 1485例住院患者）进行了重复分析，所有数据集均已完成CRB和CRB-65.干预。没有。30-通过个人接触或结构化访谈确定CAP的日死亡率。总的30天死亡率为4.3%（门诊患者为0.6%，住院患者为5.5%，P < 0.0001）。总体而言，CURB、CRB和CRB-65评分对CAP死亡的预测具有可比性，如受试者-操作者特征（ROC）曲线所示。然而，在住院患者中，CRB将26%的死亡误分类为低风险患者。CRB-65评分的有效性（90%）远上级CURB评分的有效性（65%）（P < 0.001）。CURB和CRB-65评分均可用于医院和门诊患者，以评估肺炎严重程度和死亡风险。鉴于CRB-65更容易操作，我们倾向于在无法获得血尿素氮的情况下使用CRB-65。
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.