Weight of the CURB-65 Criteria for Community-Acquired Pneumonia in a Very Low-Mortality-Rate Setting
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概要
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Objective The CURB-65 score is a simple well validated tool for the assessment of severity in community-acquired pneumonia (CAP). The weight of each criterion in very low-mortality-rate settings is unclear. The purpose of this study was to determine the weight in such setting. Methods This study retrospectively reviewed 1,230 adult patients admitted for CAP from 2005 to 2009. Results The 30-day mortality rose sharply from 0%, 1.0%, 8.2% and 16.7%, respectively, for patients with CURB-65 scores of 0, 1, 2 and 3 to 100.0% for patients with the scores of 4 (x2 = 219.494, p<0.001). Confusion had the strongest association with mortality (odds ratio, 22.148). The presence of low blood pressure was not associated with mortality. Confusion, urea >7 mmol・L-1 and age ≥65 yrs showed independent relationships with mortality (Odds ratio, 11.537, 5.988 and 10.462; respectively). Urea >7 mmol・L--1 was most strongly associated with the sequential organ failure assessment (SOFA) scores [rank correlation coefficient (rs), 0.352]. Confusion had the closest relationship with hospital length of stay (rs, 0.114). Age ≥65 yrs had the strongest association with costs (rs, 0.223). Conclusion The individual CURB-65 criteria were of unequal weight for predicting the 30-day mortality, SOFA scores, hospital length of stay and costs in a very low-mortality-rate setting, and a low blood pressure was not associated with mortality.
著者
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Guo Qi
Department Of Internal Medicine And Rehabilitation Science Tohoku University Graduate School Of Medi
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Chen Xia
Department of Natural Medicinal Chemistry, China Pharmaceutical University
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Liu Nian
Department Of Chemistry And Shanghai Key Laboratory Of Molecular Catalysis And Innovative Materials
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Li Ming
Department Of Bioproductive Science Faculty Of Agriculture Utsunomiya University
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LIU Hui
Department of Anesthesiology, West China Second University Hospital, Sichuan University
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Jiang Mei
Guangzhou Institute of Respiratory Diseases (State Key Laboratory of Respiratory Diseases), First Affiliated Hospital, Guangzhou Medical University, China
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Zhou Yi-ping
Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, China
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Li Hai-yan
Department of Primary Care, Affiliated Futian Hospital, Guangdong Medical College, China
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Chen Xiao-ke
Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, China
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Peng Hong-lin
Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, China
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Yu Hai-qiong
Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, China
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Liang Li-hua
Department of Radiology, Affiliated Futian Hospital, Guangdong Medical College, China
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Zhao Qing-zhou
Department of Radiology, Affiliated Futian Hospital, Guangdong Medical College, China
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Chen Xia
Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, China
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Li Ming
Department of Anatomy & Neurobiology, School of Basic Medicine, Central South University
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Liu Hui
Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, China
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