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Serum High-Sensitivity C Reactive Protein Improves Sensitivity of CURB-65 in Predicting ICU Admission and Mortality in Community-Acquired Pneumonia Patients by Yan L. Ge, Cong H. Liu, Jing Xu, Zi Y. Cui, Wei C. Guo, Hui L. Li, Ai S. Fu, Hong Y. Wang, Hai F. Zhang, Xiao Y. Zhu

Background: The CURB-65 scoring system is a simple tool in assessment and prognosis prediction for communityacquired pneumonia (CAP) patients. However, the variations in performance of CURB-65 in young and elderly patients, underestimation or overestimation of the severity, and mortality have often been reported. The aim of this study was to investigate the usefulness of serum high-sensitivity C reactive protein (hs-CRP) combined with CURB-65 in predicting ICU admission and 30-day mortality in CAP patients.
Methods: We conducted a retrospective study. All patients over 18 years of age with a primary diagnosis of CAP were included, all of them received serum hs-CRP test and CURB-65 scaring evaluation. The main outcome measures were ICU admission and 30-day mortality. Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of the CURB-65 model and hs-CRP combined CURB-65 augmented model in predicting the main outcomes.
Results: Data from 150 patients was analyzed, in which the rate for patients requiring ICU admission was 30.67%, and the ultimate mortality rate was 24%. The areas of ROC curves (AUC) of CURB-65 was 0.859 (95% CI 0.705 to 1.000), hs-CRP combined CURB-65 augmented model was 0.864 (95% CI 0.692 to 1.000), ROC curve analyses showed the augmented model had higher sensitivity than the CURB-65 model in predicting main outcomes (p = 0.001).
Conclusions: Measurement of serum hs-CRP in addition to the CURB-65 model improved the clinical usefulness in predicting ICU admission and mortality in CAP patients.

DOI: 10.7754/Clin.Lab.2018.180536