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18-01-2011 | Respiratory | Article

CURB65 scores indicate mortality risk in patients with COPD exacerbations

Abstract

Free abstract

MedWire News: CURB65 scores indicate 30-day mortality risk among patients with chronic obstructive pulmonary disease (COPD) who have been admitted to hospital for an exacerbation, say researchers.

"Hospitalization for COPD exacerbation usually occurs during advanced stages of the disease and the outcome is often poor," explain Catherina Chang (Waikato Hospital, Hamilton, New Zealand) and team.

But they add that there are currently no effective methods for assessing mortality risk among such patients.

The British Thoracic Society CURB65 score is a widely used prognostic scoring system for community-acquired pneumonia, and could potentially be used to estimate mortality risk after COPD exacerbation-related hospitalization, remark Chang et al.

To investigate, they studied 249 patients suffering from a COPD exacerbation who were admitted to hospital over a 1-year period between 2006 and 2007.

CURB65 scores, ranging from 0 to 6, were calculated for each patient using information obtained at initial hospital presentation, with one point each assigned for the presence of confusion, a urea level greater than 7 mmol/l, a respiratory rate equal to or greater than 30 breaths per minute, a systolic or diastolic blood pressure level below 90 or 60 mmHg, respectively, and age greater than 65 years.

In total, 21 (8.4%) patients died within 30 days of being admitted to hospital.

The researchers found that CURB65 scores on hospital admission significantly predicted risk for death within 30 days. Indeed, 30-day mortality rates were 2.0%, 6.7%, and 21.3% among patients with CURB65 scores of 0-1 (low risk, n=98), 2 (intermediate risk, n=90), and 3-5 (high risk, n=61), respectively.

However, there was no significant association between CURB65 scores on hospital admission and 1-year mortality rates, the researchers note.

Chang and team conclude: "We have found that the CURB65 score predicts short-term mortality following an exacerbation of COPD requiring admission to hospital.

"This is the first time that a risk stratification score has been demonstrated to be successful for acute exacerbations of COPD."

They add: "Our findings suggest that CURB65 can help clinicians to assess patients with this condition."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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