ABSTRACT
Objective To evaluate the prognosis of patients with sepsis in the emergency department using the modified CURB-65 score.Methods We retrospectively analyzed the clinical data of 143 patients with sepsis who were first diagnosed at the emergency department of the First Hospital of China Medical University (between January 2014 and January 2015),assessed their CURB-65 and sequential organ failure assessment (SOFA) scores,and modified the CURB-65 scoring system by adding some indexes of the prognosis of sepsis.We analyzed the prognostic value of each scoring systems in the diagnosis of sepsis using the receiver-operating characteristic curve.Results The modified CURB-65,CURB-65,and SOFA scores had independent abilities for early prediction of the prognosis of sepsis.The area under the curve and the Youden index of the modified CURB-65 score were highest,which are superior to the traditional CURB-65 and SOFA scores.Conclusion The modified CURB-65 score can predict the prognosis of sepsis in its early stage.In addition,the assessment method is simple and convenient;hence,it is useful for assessing the condition of patients with sepsis and providing an early treatment.
ABSTRACT
Objective To evaluate the clinical application value of modified CURB-65 score for assessing severity of community-acquired pneumonia (CAP) in emergency patients.Methods During the period from May 2011 to May 2012,198 emergency patients with CAP enrolled in this study were evaluated by CURB-65 score and modified CURB-65 score,respectively.Based on the severity of CAP,patients were divided into mild pneumonia group (Group A,n =107) and severe pneumonia group (Group B,n =91).The clinical status and biomarkers (the white blood cell count,procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses) were recorded and compared with t test.Group B was divided into survived-subgroup (n =62) and death-subgroup (n =29).The differences in CURB-65 score and modified CURB-65 scere between the two groups were compared with t test.The correlation of CURB-65 score and modified CURB-65 score with procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses were determined with Pearson rank correlation method.Results The procalcitonin,pneumonia severity index,hospitalization days,hospitalization expenses,modified CURB-65 score and CURB-65 score in Group B were significantly higher than those in Group A [(3.70 ± 0.83) vs.(1.27±0.24),t=28.91,P＜0.01; (121.33±16.74) vs.(73.79±9.21),t=25.23,P＜0.01;(25.79±10.13) vs.(14.85 ±6.83),t=9.02,P＜0.01; (22.71 ±3.84) vs.(9.83 ±1.24),t=32.76,P＜0.01; (3.69±1.03) vs.(3.32±1.06),t=2.48,P＜0.05; (4.21±1.13) vs.(3.41±0.96),t =5.39,P＜0.01],while no significant difference was observed in the white blood cell count between GroupA and B (17.58 ±5.99 vs.16.86±4.41,t =0.97,P＞0.05).For Group B,the modified CURB-65 score of death-subgroup was significantly higher than that of survived-subgroup [(4.75± ± 1.17) vs.(4.01 ± 1.09),t =2.95,P ＜ 0.01],whilc no significant difference was observed in the CURB-65 score between the death-subgroup and survived-subgroup (4.01 ± 1.15 vs.3.58 ±0.97,t =1.86,P ＞ 0.05).The CURB-65 score positive correlated with the procalcitonin (r =-0.803,P =0.025),and had no obvious correlation with the pneumonia severity index,hospitalization days,and hospitalization expenses (r=0.621,P=0.320; r=0.701,P=0.231; r=0.675,P=0.256); The modified CURB-65 score significantly positively correlated with the procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses (r =0.951,P =0.003 ; r =0.965,P =0.002 ; r =0.947,P =0.004 ; r =0.961,P =0.002).Conclusions Compared with the CURB-65 score,the modified CURB-65 score is more efficient in evaluating the severity and prognoses of CAP for emergency patients.