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Free Content Compliance with the CURB-65 score and the consequences of non-implementation

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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, wellvalidated tool for the assessment of severity in communityacquired 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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Keywords: COMMUNITY-ACQUIRED PNEUMONIA; COMPLIANCE; COSTS; CURB65 SCORE; HOSPITALISATION

Document Type: Short Communication

Affiliations: 1: Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China 2: Department of Primary Care, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China 3: Department of Radiology, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China 4: Guangzhou Institute of Respiratory Diseases (State Key Laboratory of Respiratory Diseases), First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China

Publication date: December 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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