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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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.
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10.	蒋忠胜, 江建宁, 张鹭, 等. APACHEⅡ/Ⅲ评分和 SAPSⅡ评分预测肝衰竭预后的比较. 中国急救医学, 2008, 28(1): 9-11.
11.	孔庆华, 白久武, 王晓如, 等. 三种评分系统在老年社区获得性肺炎危险度分层及病情评估中的应用. 中国呼吸与危重监护杂志, 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.	洪洁, 张泓. 强化 CURB 评分在对肺炎合并免疫抑制的预测意义. 中华急诊医学杂志, 2017, 26(9): 1054-1058.
14.	谈媛媛, 张泓. 强化 CURB 和 CURB-65 对社区获得性肺炎的预后价值分析. 安徽医科大学学报, 2017, 52(4): 533-536.
15.	马文通, 张泓. CURB-65 评分和强化 CURB 评分对老年重症社区获得性肺炎预测价值的临床研究. 中国急救医学, 2016, 36(3): 238-241.
16.	李红兵, 王平飞, 王廷杰, 等. 川东北地区重症肺炎的临床特征. 重庆医学, 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.	陈万, 梁纲, 吴锋耀, 等. 广西地区老年 HIV/AIDS 病人并发重症肺炎的临床特点分析. 中国艾滋病性病, 2016, 22(12): 950-953.

1. 童朝辉, 王辰. 社区获得性肺炎. 医师进修杂志, 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. 蔡卫平, 唐小平, 黄宝浩, 等. 艾滋病合并细菌与真菌感染分析. 中国抗感染化疗杂志, 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, 蒋忠胜. 社区获得性肺炎严重程度评分系统的研究进展. 江苏大学学报 (医学版), 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, 曹大伟, 张新日. 社区获得性肺炎病情严重度评估指标预测效能的临床研究. 中国呼吸与危重监护杂志, 2018, 17(5): 456-460.
10. 蒋忠胜, 江建宁, 张鹭, 等. APACHEⅡ/Ⅲ评分和 SAPSⅡ评分预测肝衰竭预后的比较. 中国急救医学, 2008, 28(1): 9-11.
11. 孔庆华, 白久武, 王晓如, 等. 三种评分系统在老年社区获得性肺炎危险度分层及病情评估中的应用. 中国呼吸与危重监护杂志, 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. 洪洁, 张泓. 强化 CURB 评分在对肺炎合并免疫抑制的预测意义. 中华急诊医学杂志, 2017, 26(9): 1054-1058.
14. 谈媛媛, 张泓. 强化 CURB 和 CURB-65 对社区获得性肺炎的预后价值分析. 安徽医科大学学报, 2017, 52(4): 533-536.
15. 马文通, 张泓. CURB-65 评分和强化 CURB 评分对老年重症社区获得性肺炎预测价值的临床研究. 中国急救医学, 2016, 36(3): 238-241.
16. 李红兵, 王平飞, 王廷杰, 等. 川东北地区重症肺炎的临床特征. 重庆医学, 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. 陈万, 梁纲, 吴锋耀, 等. 广西地区老年 HIV/AIDS 病人并发重症肺炎的临床特点分析. 中国艾滋病性病, 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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