Proadrenomedullin (ProADM) confers additional prognostic information to established clinical risk scores in lower respiratory tract infections (LRTI). We aimed to derive a practical algorithm combining the CURB65 score with ProADM-levels in patients with community-acquired pneumonia (CAP) and non-CAP-LRTI. We used data of 1359 patients with LRTI enrolled in a multicenter study. We chose two ProADM cut-off values by assessing the association between ProADM levels and the risk of adverse events and mortality. A composite score (CURB65-A) was created combining CURB65 classes with ProADM cut-offs to further risk-stratify patients. CURB65 and ProADM predicted both adverse events and mortality similarly well in CAP and non-CAP-LRTI. The combined CURB65-A risk score provided better prediction of death and adverse events than the CURB65 score in the entire cohort and in CAP and non-CAP-LRTI patients. Within each CURB65 class, higher ProADM-levels were associated with an increased risk of adverse events and mortality. Overall, risk of adverse events (3.9%) and mortality (0.65%) was low for patients with CURB65 score 0-1 and ProADM ≤0.75 nmol/l (CURB65-A risk class I); intermediate (8.6% and 2.6%, respectively) for patients with CURB65 score of 2 and ProADM ≤1.5 nmol/l or CURB classes 0-1 and ProADM levels between 0.75-1.5 nmol/L (CURB65-A risk class II), and high (21.6% and 9.8%, respectively) for all other patients (CURB65-A risk class III). If outpatient treatment was recommended for CURB65-A risk class I and short hospitalization for CURB65-A risk class II, 17.9% and 40.8% of 1217 hospitalized patients could have received ambulatory treatment or a short hospitalization, respectively. The new CURB65-A risk score combining CURB65 risk classes with ProADM cut-off values accurately predicts adverse events and mortality in patients with CAP and non-CAP-LRTI. Additional prospective cohort or intervention studies need to validate this score and demonstrate its safety and efficacy for the management of patients with LRTI. Procalcitonin-guided antibiotic therapy and hospitalisation in patients with lower respiratory tract infections: the prohosp study; isrctn.org Identifier: ISRCTN: ISRCTN95122877.
Proadrenomedullin ( ProADM ) confers additional prognostic information to established clinical risk scores in lower respiratory tract infections ( LRTI ) . We aimed to derive a practical algorithm combining the CURB65 score with ProADM - levels in patients with community - acquired pneumonia ( CAP ) and non - CAP - LRTI . We used data of 1359 patients with LRTI enrolled in a multicenter study . We chose two ProADM cut - off values by assessing the association between ProADM levels and the risk of adverse events and mortality . A composite score ( CURB65-A ) was created combining CURB65 classes with ProADM cut - offs to further risk - stratify patients . CURB65 and ProADM predicted both adverse events and mortality similarly well in CAP and non - CAP - LRTI . The combined CURB65-A risk score provided better prediction of death and adverse events than the CURB65 score in the entire cohort and in CAP and non - CAP - LRTI patients . Within each CURB65 class , higher ProADM - levels were associated with an increased risk of adverse events and mortality . Overall , risk of adverse events ( 3.9 % ) and mortality ( 0.65 % ) was low for patients with CURB65 score 0 - 1 and ProADM ≤0.75 nmol / l ( CURB65-A risk class I ) ; intermediate ( 8.6 % and 2.6 % , respectively ) for patients with CURB65 score of 2 and ProADM ≤1.5 nmol / l or CURB classes 0 - 1 and ProADM levels between 0.75 - 1.5 nmol / L ( CURB65-A risk class II ) , and high ( 21.6 % and 9.8 % , respectively ) for all other patients ( CURB65-A risk class III ) . If outpatient treatment was recommended for CURB65-A risk class I and short hospitalization for CURB65-A risk class II , 17.9 % and 40.8 % of 1217 hospitalized patients could have received ambulatory treatment or a short hospitalization , respectively . The new CURB65-A risk score combining CURB65 risk classes with ProADM cut - off values accurately predicts adverse events and mortality in patients with CAP and non - CAP - LRTI . Additional prospective cohort or intervention studies need to validate this score and demonstrate its safety and efficacy for the management of patients with LRTI . Procalcitonin - guided antibiotic therapy and hospitalisation in patients with lower respiratory tract infections : the prohosp study ; isrctn.org Identifier : ISRCTN : ISRCTN95122877 .
CURB65 score is used for stratification of which disease?
CURB65 score is used for stratification of which disease ?
pneumonia
pneumonia