title: Compliance with the CURB-65 score and the consequences of non-implementation.
abstract: 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.
authors: Department of Respiratory Medicine, Affiliated Futian Hospital, Guangdong Medical College, Shenzhen, Guangdong, China. qiguo88@hotmail.com
authors: Q
authors: Q
authors: Guo
authors: H-Y
authors: HY
authors: Li
authors: Y-P
authors: YP
authors: Zhou
authors: M
authors: M
authors: Li
authors: X-K
authors: XK
authors: Chen
authors: H
authors: H
authors: Liu
authors: H-L
authors: HL
authors: Peng
authors: H-Q
authors: HQ
authors: Yu
authors: X
authors: X
authors: Chen
authors: N
authors: N
authors: Liu
authors: L-H
authors: LH
authors: Liang
authors: Q-Z
authors: QZ
authors: Zhao
authors: M
authors: M
authors: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000191:economics / Q000503:physiopathology; D003365:Costs and Cost Analysis; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011014:Pneumonia / Q000175:diagnosis* / Q000191:economics / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012720:Severity of Illness Index