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Compliance with the CURB-65 score and the consequences of non-implementation
1Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China. qiguo88@hotmail.com
Background:
The CURB-65 (confusion, urea >7 mmol/l, respiratory rate ≥ 30 breaths/min, low blood pressure and age ≥ 65 years) score is a simple, well-validated tool for the assessment of severity in community-acquired pneumonia (CAP). It is unknown whether it is used routinely in China.
Objective:
To determine the frequency of use of the CURB-65 score in routine hospital practice and the consequences of non-implementation.
Methods:
A retrospective analysis of medical records from 1230 in-patients with CAP in a Chinese medical college-affiliated hospital.
Results:
No CAP patient underwent the CURB-65 test at admission. Based on the British Thoracic Society guidelines, the 716 (58.2%) in-patients with a CURB65 score of 0 and the 402 (32.7%) in-patients with CURB-65 score of 1 should have received ambulatory treatment, whereas the 14 (1.2%) patients with CURB65 scores of ≥ 3 should have been admitted to the critical care unit. The maximum excess total annual costs for managing CAP patients with CURB-65 scores of 0 and 1 were estimated at respectively US$94 383.12 and US$66 313.92 in the hospital.
Conclusions:
The CURB-65 scoring tool in patients with CAP was not applied in routine hospital practice, resulting in inappropriate hospitalisation and excess costs.
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