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CURB65-A (CURB65 and Proadrenomedullin) Risk Classification of Albrich et al for a Patient with a Lower Respiratory Tract Infection

Description

Albrich et al developed a risk classification for patients with lower respiratory tract infections based on the CURB65 and serum levels of proadrenomedullin. The patient's risk category can help guide management. The authors are from the University of Basel.


 

Patient selection: adult >= 59 years old with lower respiratory tract infection (community-acquired pneumonia, other)

 

Parameters:

(1) CURB65 score

(2) admission serum proadrenomedullin (proADM) concentration

CURB65

proADM < 0.75 nmol/L

proADM 0.75 to 1.5 nmol/L

proADM > 1.5 nmol/L

0 or 1

low (I)

intermediate (II)

high (III)

2

intermediate (II)

intermediate (II)

high (III)

3 to 5

high (III)

high (III)

high (III)

 

The patient is high risk if CURB65 is >= 3 OR proADM > 1.5 nmol/L.

 

The patient is low risk if CURB65 <= 1 AND proADM < 0.75 nmol/L.

 

All other patients are intermediate risk.

 

Risk Group

Management

low (I)

outpatient treatment

intermediate (II)

short hospital stay

high (III)

hospital stay based on severity

 

Limitation:

• Classification depends on accurate measurement of the proadrenomedullin concentration.

 


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Specialty

ICD-10