title: The CURB-65 scoring system in severity assessment of Eastern Nigerian patients with community-acquired pneumonia: a prospective observational study.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in Nigeria. Severity assessment is a major starting point in the proper management of CAP. The BTS guideline for managing this condition is simple and does not require sophisticated equipment. Adherence to this guideline will improve CAP management in Nigeria.
  
  
  OBJECTIVE
  To assess the usefulness of the CURB-65 score in the management of CAP patients in Nigeria and to determine the outcome in relation to the degree of severity using CURB-65.
  
  
  METHODS
  A prospective observational study of 80 patients with CAP was carried out in the University of Nigeria Teaching Hospital Enugu, Nigeria from December 2008 to June 2009. The patients were classified into three risk groups and the ability of the CURB-65 score to predict the 30-day mortality rate and the need for ICU admission was determined.
  
  
  RESULTS
  Eighty patients were recruited, 39 of whom were men, giving a male to female ratio of 1:1.05. The mean age was 56 ± 18 years. Thirty-seven patients (46.3%) were outpatients, 13 with CURB score 0, 21 with CURB score 1, two with CURB score 2, and one with CURB score 3. Of the 43 patients (53.7%) admitted to hospital, six, 13, 14, and 10 had scores of 4, 3, 2, and 1, respectively. The ICU admission rate was 10%. Twelve patients died, 2.2% in the low-risk group, 12.5% in the intermediate-risk group, and 45% in the high-risk group.
  
  
  CONCLUSIONS
  The CURB-65 score is a simple method of assessing and risk stratifying CAP patients. It is particularly useful in a busy emergency department because of its ability to identify a reasonable proportion of low-risk patients for potential outpatient care.
authors: Department of Medicine, Federal Medical Centre, Owerri, Nigeria.
authors: Godwin C
authors: GC
authors: Mbata
authors: Chinwe J
authors: CJ
authors: Chukwuka
authors: Cajetan C
authors: CC
authors: Onyedum
authors: Basden J C
authors: BJ
authors: Onwubere
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017714:Community-Acquired Infections / Q000175:diagnosis; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011014:Pneumonia / Q000175:diagnosis* / Q000401:mortality; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index
references: Thorax. 2008 May;63(5):447-52
references: 18245147
references: JAMA. 1996 Jan 10;275(2):134-41
references: 8531309
references: Respir Med. 1992 Jan;86(1):7-13
references: 1565823
references: Arch Intern Med. 1997 Jan 13;157(1):36-44
references: 8996039
references: Thorax. 2008 Aug;63(8):698-702
references: 18492742
references: Eur Respir J. 2006 Jan;27(1):151-7
references: 16387948
references: J Bras Pneumol. 2008 Sep;34(9):683-9
references: 18982205
references: Niger Med J. 1973 Jul;3(3):144-5
references: 16366348
references: Respir Med. 2011 Feb;105(2):298-302
references: 21112756
references: Am Fam Physician. 2006 Feb 1;73(3):442-50
references: 16477891
references: Crit Care Clin. 1998 Jan;14(1):105-18
references: 9448981
references: Clin Chest Med. 1995 Mar;16(1):155-71
references: 7768089
references: N Engl J Med. 1997 Jan 23;336(4):243-50
references: 8995086
references: Thorax. 2003 May;58(5):377-82
references: 12728155
references: Am J Med. 2005 Apr;118(4):384-92
references: 15808136
references: Am J Respir Crit Care Med. 2002 Mar 15;165(6):766-72
references: 11897642
references: Eur Respir J. 2004 Nov;24(5):779-85
references: 15516672
references: Thorax. 1996 Oct;51(10):1017-22
references: 8977603
references: Med J Aust. 2002 Apr 1;176(7):341-7
references: 12013330
references: JAMA. 2004 Mar 10;291(10):1238-45
references: 15010446
references: Eur Respir J. 2006 Aug;28(2):346-51
references: 16611653
references: Postgrad Med. 2005 Oct;118(4):13-4, 17
references: 16296260
references: JAMA. 2003 Jan 8;289(2):179-86
references: 12517228
references: Thorax. 2007 Apr;62(4):348-53
references: 17121867
references: Thorax. 2004 May;59(5):421-7
references: 15115872
references: Am J Respir Crit Care Med. 1998 Oct;158(4):1102-8
references: 9769267