Is CURB-65 usually in managing community acquired pneumonia?

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10 Jul 2016 - General

Community acquired pneumonia is the infection of the lung, that is acquired in community settling. And this is different from hospital acquired pneumonia. Community acquire pnuemonia can be a serious disease, particular in elderly population, and patients with other significant comorbidities. CURB-65 is 1 of the scores used as clinical prediction for the severity of community acquired pneumonia, and hence used to tailor the treatment decision. CURB-65 is based on 5 parametes, whic are, C-Confusion, U-Urea  more than 7 mmol/l, R-Resporatoty rate more than 30 per minute, B-Blood pressure (systolic less than 90 mm Hg or diastolic less than 60 mm Hg), A-Age more than 65 years old.  The risk of 30 days death increases, as the score increases, the score of 0-1 can be treated as outpatien,  score of 2 consider hospital stay. Scorre 3-5, consider hospital stay plus/minus require HDU/ICU stay...  How useful is CURB-65 in clinical settling ??? Can we just based on this score in the managment of community acquire pneumonia?  

Yes, CURB-65 indeed is a clinical prediction model, used to risk stratification of patients with community acquired pneumonia. The other validated clinical prediction model for community acquired pneumonia is Pneumonia Severity Index (PSI). The score is useful to guide us with regards to the management strategy. I agree that is just a rough estimation, because there are other significant factors of the specific patient that we need to take into account, like background co-morbidities, physo-soci...
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I use the risk stratification guideline for pneumonia from American Thoracic Society 2011. This guideline is in our national clinical practice guideline . It stratifies risk to low, intermediate and high with focus on need for intensive unit, care treatment, general ward treatment or outpatient treatment. It is certainly very much more complex than this CURB-65. In local context, our giudeline did take into consideration the environment air quality, modifying risk factor for antibiotic choice an...
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