Simple modification of CURB-65 better identifies patients including the elderly with severe CAP
- 1Department of Medicine, Queen Elizabeth Hospital, King’s Lynn, School of Medicine, Health Policy and Practice, University of East Anglia, and Department of Medicine for the Elderly, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK
- 2Department of Respiratory Medicine, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK
- 3Centre for Applied Medical Statistics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- 4School of Medicine, Health Policy and Practice, University of East Anglia and Department of Respiratory Medicine, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK
- Dr Phyo Kyaw Myint, Clinical Gerontology Unit, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, UK; Pkyawmyint{at}aol.com
We read with interest the article by Barlow et al.1 The CURB-65 criteria currently recommended by the British Thoracic Society (BTS) based on the study by Lim et al2 are useful and more pragmatic than other criteria, as shown in their study. However, CURB has a lower specificity in older patients and addition of the age 65 criterion to CURB adds nothing to the sensitivity and little to the specificity in hospitalised patients.3 Increasing the urea cut off point by 2 units produces better specificity but at the expense of reduced sensitivity.4 Recently proposed SOAR criteria (systolic BP, oxygenation, age and respiratory rate) are at least as useful as CURB-65 in older patients …
