RT Journal Article
SR Electronic
T1 Does it matter which set of observations are used to calculate the CURB65 score for pneumonia?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2482
VO 38
IS Suppl 55
A1 Manish Gautam
A1 Katya Lyulcheva
A1 Zahra Estabragh
A1 Josheel Naveed
A1 Paul Deegan
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2482.abstract
AB Background: The British Thoracic Society has recommended that the CURB65 score is applied as the initial severity assessment strategy in hospitals for community acquired pneumonia (CAP), in conjunction with clinical judgement. Evidence for the scoring system is robust and its use at initial presentation enables patients to be stratified according to increasing risk of mortality.Aim: To assess whether the CURB65 score was recorded using observations made during the initial hospital assessment or at a later stage.Methods: This was a prospective study of random CAP cases (radiologically confirmed) admitted to a large University Hospital between Jan-Feb 2011. CURB65 documentation in the case notes was studied to assess whether the score was performed on the basis of initial observations.Results: A total of 55 cases were studied (M: 25, F: 30), mean age 75 years. The CURB65 score was recorded in 44/55 (80%) cases. The score was recorded on the basis of admission observations in 70% of cases (31/44) and in 30% of cases (13/44) observations documented at a later stage. For the latter group, the documented cumulative score was 35, significantly higher than the “actual cumulative score” when calculated retrospectively using admission observations 25 (p value <0.01).Conclusions: Calculation of the CURB65 score using observations made after the initial assessment can significantly affect the score recorded. This may potentially lead to the overuse of antibiotic therapy. In order to improve the quality of care for CAP patients, measures should be taken to ensure that CURB65 is recorded appropriately.