Document Detail


Compliance in the measurement of CURB-65 in patients with community acquired pneumonia and potential implications for early discharge.
MedLine Citation:
PMID:  18624261     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The CURB-65 community-acquired pneumonia (CAP) severity score is a convenient 5-variable disease-specific tool validated to predict mortality and the decision to admit. This prospective study seeks to determine (a) the accuracy CAP diagnosis; (b) the degree to which the CURB-65 score was being documented; and (c) the degree to which CURB-65 was being utilised as an admission and early discharge tool in the A&E Department in the evaluation of patients presenting with CAP. Of 45 patients referred with an admitting diagnosis of CAP, 28 were subsequently found to satisfy the criteria of CAP, an over diagnosis of 38%. Documentation of CURB-65 was 7%; recording of core variables was 81% i.e. 4 out of 5 variables and confusion was the variable least likely to be documented. On re-scoring, 50% of patients had a score of 0 or 1 and a further 28% had a score of 2. We conclude that CAP is significantly overdiagnosed; that the CURB-65 severity score is not being utilised and that between 50 and 78% of patients with CAP may be admitted unnecessarily. This study raises important issues in the current management of CAP in the Irish Healthcare system.
Authors:
P Nadarajan; L Wilson; B Mohammed; M Connor; S J Lane
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Irish medical journal     Volume:  101     ISSN:  0332-3102     ISO Abbreviation:  Ir Med J     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-07-15     Completed Date:  2008-09-10     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0430275     Medline TA:  Ir Med J     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  144-6     Citation Subset:  IM    
Affiliation:
Department of Respiratory Medicine, AMNCH, Tallaght, Dublin.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Community-Acquired Infections / diagnosis*,  physiopathology
Female
Health Status Indicators
Humans
Lung Compliance
Male
Medical Audit
Middle Aged
Pneumonia / diagnosis*,  physiopathology
Prospective Studies
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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