The value of CURB-65 and expanded CURB-65 scores in evaluating prognosis of pneumonia in non-HIV infected patients and HIV infected patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

FU Yongjia , FU Kai , WANG Lingqin , MENG Dali ,  JIANG Zhongsheng

The Second Ward of Infectious Diseases Department, Liuzhou People’s Hospital, Liuzhou, Guangxi 545006, P. R. China;

Corresponding?author：

JIANG Zhongsheng, Email: jiangzs1111@126.com

Keywords：

Human immunodeficiency virus; Community acquired pneumonia; CURB-65 score; Expanded CURB-65 score; Prognosis

DOI：

10.7507/1671-6205.201909027

Video：

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Objective To compare the value of CURB-65 score and expanded CURB-65 score in evaluating prognosis of pneumonia in non-HIV infected patient and HIV infected patient.Methods The study included 206 hospitalized pneumonia patients without HIV infection and 299 pneumonia patients with HIV infection. According to their clinical prognosis within 4 weeks of treatment, they were divided into a deterioration group and an improvement group. The basic situation and the differences of clinical indicators between the two groups were compared. The predictive value of CURB-65 score and expanded CURB-65 score for clinical prognosis of pneumonia in non-HIV infected patients and HIV infected patients was compared by using receiver operator characteristic (ROC) curve.Results For the pneumonia patients without HIV infection, the area under ROC curve (AUC) of CURB-65 score and expanded CURB-65 score were 0.862 and 0.848, respectively. There was no significant difference in AUC between CURB-65 score and expanded CURB-65 score (Z=0.661, P=0.5084). The Youden indexes of CURB-65 score and expanded CURB-65 score were 60.11% and 54.92%, respectively. For the pneumonia patients with HIV infection, the AUC of CURB-65 score and expanded CURB-65 score were 0.588 and 0.634, respectively. There was no significant difference between them (Z=1.416, P=0.1567). The Youden index of the two scores was 19.53% and 20.52%, respectively.Conclusions The CURB-65 score and expanded CURB-65 score can effectively evaluate the clinical prognosis of pneumonia in non-HIV infected patients, but their predicted values are limited in evaluating the prognosis of pneumonia in HIV infected patients.

Citation： FU Yongjia, FU Kai, WANG Lingqin, MENG Dali, JIANG Zhongsheng. The value of CURB-65 and expanded CURB-65 scores in evaluating prognosis of pneumonia in non-HIV infected patients and HIV infected patients. Chinese Journal of Respiratory and Critical Care Medicine, 2020, 19(4): 346-350. doi: 10.7507/1671-6205.201909027 Copy

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12.	Kollef KE, Reichley RM, Micek ST, et al. The modified APACHE II score outperforms Curb65 pneumonia severity score as a predictor of 30-day mortality in patients with methicillin-resistant Staphylococcus aureus pneumonia. Chest, 2008, 133(2): 363-369.
13.	洪潔, 張泓. 強化 CURB 評分在對肺炎合并免疫抑制的預測意義. 中華急診醫學雜志, 2017, 26(9): 1054-1058.
14.	談媛媛, 張泓. 強化 CURB 和 CURB-65 對社區獲得性肺炎的預后價值分析. 安徽醫科大學學報, 2017, 52(4): 533-536.
15.	馬文通, 張泓. CURB-65 評分和強化 CURB 評分對老年重癥社區獲得性肺炎預測價值的臨床研究. 中國急救醫學, 2016, 36(3): 238-241.
16.	李紅兵, 王平飛, 王廷杰, 等. 川東北地區重癥肺炎的臨床特征. 重慶醫學, 2013, (31): 3757-3758, 3763.
17.	Wu L, Zhang Z, Wang Y, et al. A model to predict in-hospital mortality in HIV/AIDS patients with pneumocystis pneumonia in China: the clinical practice in real world. Biomed Res Int, 2019, 2019(4): 11.
18.	Wang M, Dong X, Huang Y, et al. Activation of the kynurenine pathway is associated with poor outcome in Pneumocystis pneumonia patients infected with HIV: results of 2 months cohort study. BMC Infect Dis, 2019, 19(1): 223.
19.	陳萬, 梁綱, 吳鋒耀, 等. 廣西地區老年 HIV/AIDS 病人并發重癥肺炎的臨床特點分析. 中國艾滋病性病, 2016, 22(12): 950-953.

1. 童朝輝, 王辰. 社區獲得性肺炎. 醫師進修雜志, 2004, 27(11): 3-5.
2. Garnacho-Montero J, Barrero-García I, Gómez-Prieto MG, et al. Severe community-acquired pneumonia: current management and future therapeutic alternatives. Expert Rev Anti Infect Ther, 2018, 16(9): 667-677.
3. Lopera MM, Lemos Y. Prevalence of opportunistic infections in insured patients with HIV and their association with socioeconomic and clinical factors in Colombia, 2012. Biomedica, 2019, 39(1): 186-204.
4. 蔡衛平, 唐小平, 黃寶浩, 等. 艾滋病合并細菌與真菌感染分析. 中國抗感染化療雜志, 2002, 2(4): 225-228.
5. Liu JL, Xu F, Zhou H, et al. Expanded CURB-65: a new score system predicts severity of community acquired pneumonia with superior efficiency. Sci Rep, 2016, 6: 229-236.
6. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis, 2007, 44(Suppl 2): S27-S72.
7. 汪玲琴, 蔣忠勝. 社區獲得性肺炎嚴重程度評分系統的研究進展. 江蘇大學學報 (醫學版), 2019, 29(1): 87-92.
8. Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax, 2003, 58(5): 377-382.
9. 王健珍, 曹大偉, 張新日. 社區獲得性肺炎病情嚴重度評估指標預測效能的臨床研究. 中國呼吸與危重監護雜志, 2018, 17(5): 456-460.
10. 蔣忠勝, 江建寧, 張鷺, 等. APACHEⅡ/Ⅲ評分和 SAPSⅡ評分預測肝衰竭預后的比較. 中國急救醫學, 2008, 28(1): 9-11.
11. 孔慶華, 白久武, 王曉如, 等. 三種評分系統在老年社區獲得性肺炎危險度分層及病情評估中的應用. 中國呼吸與危重監護雜志, 2018, 17(2): 138-143.
12. Kollef KE, Reichley RM, Micek ST, et al. The modified APACHE II score outperforms Curb65 pneumonia severity score as a predictor of 30-day mortality in patients with methicillin-resistant Staphylococcus aureus pneumonia. Chest, 2008, 133(2): 363-369.
13. 洪潔, 張泓. 強化 CURB 評分在對肺炎合并免疫抑制的預測意義. 中華急診醫學雜志, 2017, 26(9): 1054-1058.
14. 談媛媛, 張泓. 強化 CURB 和 CURB-65 對社區獲得性肺炎的預后價值分析. 安徽醫科大學學報, 2017, 52(4): 533-536.
15. 馬文通, 張泓. CURB-65 評分和強化 CURB 評分對老年重癥社區獲得性肺炎預測價值的臨床研究. 中國急救醫學, 2016, 36(3): 238-241.
16. 李紅兵, 王平飛, 王廷杰, 等. 川東北地區重癥肺炎的臨床特征. 重慶醫學, 2013, (31): 3757-3758, 3763.
17. Wu L, Zhang Z, Wang Y, et al. A model to predict in-hospital mortality in HIV/AIDS patients with pneumocystis pneumonia in China: the clinical practice in real world. Biomed Res Int, 2019, 2019(4): 11.
18. Wang M, Dong X, Huang Y, et al. Activation of the kynurenine pathway is associated with poor outcome in Pneumocystis pneumonia patients infected with HIV: results of 2 months cohort study. BMC Infect Dis, 2019, 19(1): 223.
19. 陳萬, 梁綱, 吳鋒耀, 等. 廣西地區老年 HIV/AIDS 病人并發重癥肺炎的臨床特點分析. 中國艾滋病性病, 2016, 22(12): 950-953.

Chinese Journal of Respiratory and Critical Care Medicine

The value of CURB-65 and expanded CURB-65 scores in evaluating prognosis of pneumonia in non-HIV infected patients and HIV infected patients

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