Debjit Mitra1, Uttiya Roy2, Abhay Kumar Sinha3, Shiv Shankar Bharti4
BACKGROUND
A variety of organisms cause community-acquired pneumonia, including bacteria,
viruses and fungi. Pathogens vary in age and other factors, but the relative
importance of each pneumonia as a cause of community-acquired pneumonia
remains uncertain because most patients do not undergo thorough testing and
because even when tested, specific agents are found in < 50 percent of cases.
This study was conducted to evaluate a severity scoring system for community
acquired pneumonia and compare it with the standard confusion, urea, respiratory
rate, blood pressure and 65 years of age or older (CURB-65) scoring system in a
tertiary care centre in Patna Medical College.
METHODS
This hospital based prospective study was conducted among 100 consecutive
patients of community-acquired pneumonia (CAP) attending OPD or getting
admitted in General Medicine ward of Patna Medical College. The CURB-65 and
Expanded CURB-65 scores for these patients were calculated and the accuracy of
either in predicting outcomes was statistically analysed, during the period
September 2018 - May 2019.
RESULTS
The mean age of CAP patients in our study was 59.09 ± 12.942 years, the most
common co-morbidity observed was diabetes mellitus followed by chronic
obstructive pulmonary disorders (COPD), cardiovascular disease, chronic liver
disease and chronic renal disease. Our study showed that the mortality rate of the
study population was 12 % and 30 % patients needed admission in the ICU and
24 % patients needed invasive mechanical ventilation. In the above analysis for
30-day mortality rate, ICU admission rate, and the need for mechanical ventilation
among 0 - 2 and 3 - 5 CURB 65 scores, we found no statistically significant
difference (P-value = > 0.05).
CONCLUSIONS
The extended CURB-65 score gives priority to both clinical and laboratory
parameters and is a more accurate marker for the evaluation of CAP severity and
may boost the effectiveness of predicting mortality in CAP patients compared to
the current CURB-65 score system.
