0
Abstract: Slide Presentations |

CURB-65 IN PREDICTING THE NEED FOR MECHANICAL VENTILATION IN PATIENTS WITH BACTEREMIC PNEUMOCOCCAL PNEUMONIA FREE TO VIEW

Ghulam Khaleeq, MD*; H. A. Ali, MD; U. Mundathaje, MD; S. K. Goldberg, MD; M. L. Lippmann, MD
Author and Funding Information

Albert Einstein Medical Center, Philadelphia, PA


Chest


Chest. 2007;132(4_MeetingAbstracts):448. doi:10.1378/chest.132.4_MeetingAbstracts.448
Text Size: A A A
Published online

Abstract

PURPOSE: Community-acquired pneumonia leads to 1.7 million hospital admissions in the United States and is the most common cause of death from infection. Streptococcus pneumonia is an important and well-known cause of bacteremia in both immunocompetent and immunosuppressed patients with pneumonia. The CURB-65 score is an algorithm based upon five easily measurable factors from which its name is derived (Confusion, Urea >20mg/dl, Respiratory rate >30, Blood pressure systolic <90 and diastolic <60 and Age >65). The aim of the study was to assess the utility of CURB-65 score in predicting the need of ICU admission and mechanical ventilation.

METHODS: We conducted a retrospective observational study between January 2006 and February 2007 in our tertiary care facility, in patients with bacteremic pneumococcal pneumonia. Data collection included: CURB-65 score, risk factors for bacteremia, antibiotics used, the need for ICU admission, mechanical ventilation and 28 day mortality. Relationships were examined using Chi-Square statistic with p < 0.05 as significant. This study was approved by our University Institutional Review Board.

RESULTS: Forty-five patients were studied. They had a mean age of 56 years; 20 were males. The mean CURB-65 score on admission was 1.6(range 0-4) Nine patients required mechanical ventilation. There was no statistically significant relationship between CURB-65 and mechanical ventilation. 14 patients needed ICU admission with an Odds ratio of 3.1 favoring patients with higher CURB-65 score. Antibiotic therapy was started with ceftriaxone/azithromycin in 21/45=46% of patients. Risk factors for bacteremia included HIV in 14 patients, malignancies 5, COPD 8, CHF 5, liver disease 11, diabetes 10, alcohol abuse 7 and renal failure in 3 patients. Mortality occurred in 5/45 = 11% of patients.

CONCLUSION: CURB-65 failed to predict the need for mechanical ventilation in patients with bacteremic pneumococcal pneumonia.

CLINICAL IMPLICATIONS: CURB-65 remains a desirable guide for predicting the need for hospital admission and ICU care but should not be used for predicting the need for mechanical ventilation.

DISCLOSURE: Ghulam Khaleeq, None.

Monday, October 22, 2007

2:30 PM - 4:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
CHEST Collections
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543