A Clinical Study About The Prognostic Value Of CURB-65 And Enhanced CURB Scores In The Elderly With Severe Community Acquired Pneumonia

Objective:Compare the values of CURB-65 and enhanced CURB scores in predicting mortality in older adults with severe community-acquired pneumonia.Methods:The 87 older adults with severe community-acquired pneumonia hospitalized into emergency department, respiratory and elderly respiratory from December 2009 to July 2015 were collected retrospectively and analyzed, CURB-65 and enhanced CURB scores were calculated respectively, the CURB-65 and enhanced CURB scores were divided into low-risk and high-risk group, Comparing the difference of mortality between the low-risk group with high-risk group in CURB-65 and enhanced CURB scores respectively. According to prognosis of 28 days for the end of observation, drawing the receiver-operating characteristic(ROC) curve of the two scores and comparing their area under the curve(AUC) to determine the predictive value of prognosis.Results:The CURB-65 and enhanced CURB scores of 87 patients were 3(2-3) and 11(10-12) respectively. In the CURB-65 score, low-risk group’s mortality was 25.71%, mortality in high-risk group was 48.07%, there was no difference between low-risk group with high-risk group(P>0.05); in the enhanced CURB score, the mortality of low-risk group was 5.88%, the mortality of high-risk group was 47.14%, the mortality of high-risk group was higher than that of low-risk group(P=0.002). The CURB-65 and enhanced CURB scores of the death group were higher than those of the survival group(P<0.05).The AUC of enhanced CURB score was 0.722, the best cut-off value was 12(sensitivity 58.82%,specificity 69.81%,P=0001);the AUC of CURB-65 score was 0.660, the best cut-off value was 3(sensitivity73.53%,specificity 49.06%,P=0.0091). The AUC of enhanced CURB were larger than that of CURB-65 (0.722vs0.660, z=2.176,P=0.029).Conclusions:1. CURB-65 and enhanced CURB scores all can predict the mortality of the older patients with SCAP, and enhanced CURB performed better than CURB-65,the specificity was higher than that of the CURB-65 score.2. Enhanced CURB score could be a reference that whether the patients should be admitted to ICU.