Abstract
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. KEYWORDS CAP, CURB-65, Expanded CURB-65
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