Addenbrooke's University Hospital, Cambridge, Cambridgeshire CB2 0QQ, UK ; School of Medicine & Dentistry, Division of Applied Health Sciences, C/o Room 4013, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK.
Biomed Res Int. 2013;2013:590407. doi: 10.1155/2013/590407. Epub 2013 Aug 20.
The study aims to assess the usefulness of age-independent criteria CURSI and temperature adjusted CURSI (CURASI) compared to CURB-65 in predicting community-acquired pneumonia (CAP) mortality. The criteria, CRSI and CRASI, were adapted for use in primary care and compared to CRB-65.
A retrospective analysis of a prospectively identified cohort of community-acquired pneumonia inpatients was conducted. Outcomes were (1) mortality and (2) mortality and/or ICU admission within six weeks.
95 patients (median age = 61 years) were included. All three criteria had similar sensitivity in predicting mortality alone, with CURB-65 having slightly higher specificity. When predicting mortality and/or intensive care admission, CURSI/CURASI showed higher sensitivity and slightly lower specificity. CRSI and CRASI had higher sensitivity and lower specificity when compared with CRB-65 for predicting both primary and secondary outcomes. Results for both analyses had P values >0.05.
In a cohort of younger patients CURSI and adjusted CURSI perform at least as well as CURB-65, with a similar trend for CRSI and adjusted CRSI compared to CRB-65. Further studies are needed in different age groups and in primary and secondary care settings.
本研究旨在评估年龄独立标准 CURSI 和温度调整 CURSI（CURASI）与 CURB-65 相比在预测社区获得性肺炎（CAP）死亡率方面的有用性。CRSI 和 CRASI 标准经过改编，可用于初级保健，并与 CRB-65 进行比较。
对前瞻性确定的社区获得性肺炎住院患者队列进行回顾性分析。结局为（1）死亡率和（2）6 周内死亡率和/或 ICU 入院。
共纳入 95 例患者（中位年龄=61 岁）。三种标准单独预测死亡率的敏感性相似，CURB-65 的特异性略高。在预测死亡率和/或重症监护病房入院时，CURSI/CURASI 的敏感性更高，特异性略低。与 CRB-65 相比，CRSI 和 CRASI 预测主要和次要结局的敏感性更高，特异性更低。两种分析的结果 P 值均>0.05。
在年轻患者队列中，CURSI 和调整后的 CURSI 的表现至少与 CURB-65 一样好，CRSI 和调整后的 CRSI 与 CURB-65 相比也有类似的趋势。需要在不同年龄组和初级及二级保健环境中进行进一步研究。
