Effectiveness of using CURB-65 to predict severe community-acquired pneumonia in adults at Yang Chum Noi hospital, Sisaket province
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Abstract
This retrospective cohort study aimed to evaluate the effectiveness and accuracy of the CURB-65 score in predicting severe community-acquired pneumonia among adult patients admitted to Yang Chum Noi Hospital, Sisaket Province. The CURB-65 score was determined using information recorded at admission, and the occurrence of severe community-acquired pneumonia was subsequently assessed during hospitalization. Medical records of 356 patients with community-acquired pneumonia admitted between 1 January 2023 and 31 December 2025 were reviewed. Of these, 227 patients had non-severe community-acquired pneumonia and 129 had severe community-acquired pneumonia. Data on general characteristics, comorbidities, CURB-65 components, and clinical outcomes were collected. Data were analyzed using descriptive and inferential statistics, including univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis. Data retrieval, recording, verification, and analysis were conducted between 5 December 2025 and 30 June 2026.
The results showed that each one-point increase in the CURB-65 score was associated with increased odds of severe community-acquired pneumonia after adjustment for sex, age, and comorbidities (adjusted OR = 6.17, 95% CI: 4.17–9.15, p < 0.001). CURB-65 alone demonstrated good discriminatory ability, with an AUROC of 0.839 (95% CI: 0.798–0.876). The optimal cut-off score was ≥2, with a sensitivity of 90.7%, specificity of 60.4%, positive predictive value of 56.5%, negative predictive value of 91.9%, and accuracy of 71.3%. When CURB-65 was added to the baseline model comprising sex, age, and comorbidities, the AUROC increased from 0.6015 to 0.8795, with an AUROC difference of 0.2779 (95% CI: 0.2165–0.3394, p < 0.001). In conclusion, the CURB-65 score has the ability to screen and discriminate patients with severe community-acquired pneumonia and may be used to support clinical monitoring, care planning, and referral decisions in community hospitals. However, it should be used in conjunction with physicians’ clinical assessment.
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เนื้อหาและข้อมูล (เขียนข้อกำหนด)
References
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