Abstract
Background: Community-acquired pneumonia [CAP] is common and potentially fatal; on presentation to hospital, British Thoracic Society guidelines recommend using the CURB65 severity assessment tool[i].
Aims: This study aimed to compare outcomes when the recommendations were followed with when they were not, looking at mortality, length of stay and ICU/HDU admission. Previous studies of CAP have indicated poor recording of CURB65. This may result in unnecessary admissions and inappropriate antibiotic prescriptions[ii].
Methods: This was a retrospective study of cases of clinico-microbiologically proven CAP at a district general hospital between April 2015 and January 2016. We examined 130 cases: 61 were deemed suitable for inclusion. We recorded 30-day mortality, length of stay and whether or not the patient was admitted to ICU or HDU.
Results: CURB65 was recorded correctly in 18 (30%) cases.
When CURB65 was recorded correctly: · Median length of stay was shorter (4 days).
When CURB65 was not recorded: · 30-day mortality increased from 0 to 23%: CURB65 was not recorded in any of the 9 patients who died.
· Median length of stay increased to 7.5 days.
Critical care admissions: · Out of 10 admissions CURB65 was recorded once.
| CURB65 recorded? | Number of cases (% of cases) | Median length of stay (days) | Number admitted to critical care | Number of patients who died within 30 days (% of these cases) |
| Yes | 18 (30) | 4.0 | 1 | 0 (0) |
| No | 40 (66) | 7.5 | 9 | 9 (23) |
| Yes, but incorrectly | 3 (5) | 2.0 | 0 | 0 (0) |
Effects of recording CURB65
Conclusions: All outcomes investigated were better when guidelines were followed.
[i]Lim WS, et al. Thorax. 64(Suppl 3):iii1-iii55.
[ii] Nadarajan P, et al. Ir Med J.101(5);144-146.
- Copyright ©the authors 2016
