The CURB-65 criteria as a prognostic tool in bacteriemic patients admitted due to community-acquired pneumonia

Objectives: CURB-65 is the key procedure in evaluation of CAP severity at admittance. In this retrospective study we aimed to evaluate the usefulness of CURB-65 criteria in admitted patients with positive hemoculture. We analyzed the predictive value of CURB-65 criteria in average duration of hospital stay and mortality.

Methods: We collected data regarding age, sex, bacteria isolated from blood, presence of confusion, blood urea, respiratory rate, blood pressure, serum creatinine (SC), C-reactive protein (CRP), white cell count (WCB), length of hospital stay (DH) and outcome of therapy.

Results: The total number of patient screened was 77, 43 males and 34 females. Median age was 74.5 years (range 30–99 years). Average duration of hospital stay was 13.5 days with 16.5% mortality. Positive CURB-65 criteria were: acute confusion, blood urea >8.3mmol/l, respiratory rate 30/min, diastolic BP ≤60mmHg or systolic BP ≤90mmHg and age >65 years. Bacteria most often isolated from blood were: E. coli in 29 patients, S. pneumoniae in 10 patients, K. pneumoniae in 6 patients and Methicillin-sensitive S. aureus (MSSA) in 6 patients.

Conclusion: According to results CURB-65 is a good indicator of patients at risk, indicates their prognosis, length of hospital stay and outcome also in patients with bacteriemia. Bacteriemic CAP in elderly cold be presented even with mild clinical course and good prognosis. We found higher levels of serum creatinine a predictor of higher mortality. Highest CURB-65 score is a bad prognostic sign connected with over 50% mortality