TY - JOUR T1 - CURB-65 and mortality in pneumonic and non-pneumonic exacerbations of COPD JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p569 AU - John Steer AU - G. John Gibson AU - Stephen C. Bourke Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p569.abstract N2 - Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) requiring hospitalisation are often complicated by consolidation. In patients with pneumonia and AECOPD (pAECOPD) the CURB-65 prediction tool is widely used yet its utility in this population is uncertain.Objective: To assess the effect of pneumonia on outcome, and the utility of CURB-65, in AECOPD.Method: Patients hospitalised with AECOPD were recruited prospectively, with clinical data and CURB-65 collected on admission. Pneumonia was defined as the presence of new consolidation visible radiographically.Results: Of 920 patients recruited, 299 (32.5%) had complicating pneumonia. Patients with pAECOPD were significantly older (mean age 75.7 v. 71.8 years); more often male (50.8% v. 43.8%); and had slightly better preserved ventilatory function (FEV1 45.5 v. 42.9% predicted).In-hospital mortality was higher in pAECOPD than npAECOPD (20.1% versus 6%; p<0.001) and mortality for each CURB-65 group is shown in table 1:View this table:Mortality for CURB-65 groupsArea under the ROC curve for CURB-65 against in-hospital mortality was 0.66 (95% CI 0.58–0.74) for pAECOPD and 0.72 (95% CI 0.63–0.81) for npAECOPD.Conclusion: In pAECOPD, risk of death is significantly greater than npAECOPD, and is higher than predicted by CURB-65. CURB-65 is a less good predictor of in-hospital mortality in pAECOPD than previously reported in CAP, and other prediction tools may be required for this population. ER -