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Chest Infections |

CURB 65 or CURB (S) 65 for Community-Acquired Pneumonia?

Nurdan Köktürk; Sakine Nazik Bahçecioğlu, MD; Ayse Baha; Canan Gunduz; Sezai Tasbakan; Abdullah Sayiner; Aysin Coskun; Feride Durmaz; Aykut Cilli; Burcu Celenk; Oguz Kilinc; Seda Salman; Armagan Hazar; Fatma Tokgoz
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Gazi University School of Medicine, Department of Pulmonary Medicine, Ankara, Turkey; Gazi University School of Medicine, Department of Pulmonary Medicine, Ankara, Turkey; Gazi University School of Medicine, Department of Pulmonary Medicine, Ankara, Turkey; Ege University School of Medicine, Department of Pulmonary Medicine, Izmir, Turkey; Ege University School of Medicine, Department of Pulmonary Medicine, Izmirtur, Turkey; Celal Bayar University School of Medicine, Department of Pulmonary Medicine, Manisa, Turkey; Akdeniz University School of Medicine, Department of Pulmonary Medicine, Antalya, Turkey; Dokuz Eylul University School of Medicine, Department of Pulmonary Medicine, Izmir, Turkey; Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Istanbul, Turkey


Chest. 2015;148(4_MeetingAbstracts):116A. doi:10.1378/chest.2273736
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Abstract

SESSION TITLE: Chest Infections Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: The CURB-65 score is sensitive for determining patients with severe illness yet lacks sensitivity towards other factors dealing with milder cases. The purpose of this study was to investigate factors that determine the need for hospitalization patients not requiring hospitalization according to CURB-65.

METHODS: The study was undertaken on 964 patients diagnosed with community-acquired pneumonia who were hospitalized and recorded to the Turkish Thorasic Society Pneumonia Study Group Database. Patients were categorized into 2 groups according to CURB-65 score 0-1 (Group 1) and CURB-65 score 2 and higher (Group 2).

RESULTS: 247 of the total of 964 patients were categorized into Group 1 while 717 of them were Group 2. The mean age of Group 1 was 49.3 years and Group 2 was 71.4 years (p=0.0001). The average paO2 value of Group 1 was 63,4 while for Group 2 this value was 59,6. Co-existing morbidities (COPD, DM, CVI,heart failure) were present in 179 patients in Group 1 and in 640 patients in Group 2 (p=0.0001). The mean duration of hospitalization was 14,18 ± 5,39 days in Group 1 and 15,85 ± 8,88 days in Group 2 (p=0,468). The rates of mortality were 3,64% (n=9) in Group 1 and 11,42% (n=82) in Group 2 (p=0,0001). Saturations were below 90% in 55,5% (n=5) of the deaths in Group 1 and 56,09% (n=46) of the deaths in Group 2. The mean PSI scores in Group 1 was 67,27 ± 27,13) and in Group 2 was 109,75± 32,67 (p=0,0001).

CONCLUSIONS: When considering the mean age of the groups, we believe that hospitalization for the younger patients in Group 1 was based on the fact that these patients were hypoxic for their age. Therefore we propose that the saturation parameter should be added to the CURB 65 scoring system (CURB(S) 65) as it is a better determinant for hospitalization in the younger patient group and may also serve as a predictor to determine mortality in all age groups.

CLINICAL IMPLICATIONS: By adding saturation parameter to the CURB 65 score we believe that we will have more success in identifying younger patients who require hospitalization for community acquired pneumonia. According to the results of the study saturation parameter can also be used as a predictor for the rate mortalite.

DISCLOSURE: The following authors have nothing to disclose: sakine nazik bahçecioğlu, Nurdan köktürk, Ayse Baha, Canan Gunduz, sezai tasbakan, abdullah sayiner, aysin coskun, feride durmaz, aykut cilli, burcu celenk, oguz kilinc, seda salman, armagan hazar, fatma tokgoz

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