American Thoracic Society Quick-Reference GUIDELINES Apps
Issue link: https://eguideline.guidelinecentral.com/i/88038
Diagnosis and Assessment of Disease Table 1A. CURB-65 Severity Scores for CAP Clinical Factors Confusion Blood urea nitrogen > 20 mg/dL Respiratory rate ≥ 30 breaths/min Systolic blood pressure < 90 mm Hg or diastole ≤ 60 Age > 65 Years Total Points: CURB-65 Score 0 1 2 3 4 or 5 Deaths (%)* 0.6 2.7 6.8 14.0 27.8 Recommendations† Low risk; consider home treatment Low risk; consider home treatment Admit to ward Severe pneumonia; hospitalize and consider admitting to intensive care CURB-65 = Confusion, Urea Nitrogen, Respiratory rate, Blood pressure, 65 years of age and older. *Data are weighted averages from validation studies. †Recommendations are consistent with British Thoracic Society guidelines. Clinical judgment may overrule guideline recommendations. Points 1 1 1 1 1 Table 2. Criteria for Severe Community-Acquired Pneumonia Minor Criteriaa Respiratory rateb PaO2 Multilobar infiltrates Confusion/disorientation Uremia (BUN level > 20 mg/dL) Leukopeniac /FiO2 ratiob ≥ 30 breaths/min < 250 (WBC count < 4000 cells/mm3 ) Thrombocytopenia (platelet count < 100,000 cells/mm3 Hypothermia (core temperature < 36°C) Hypotension requiring aggressive fluid resuscitation Major Criteria Invasive mechanical ventilation Septic shock with the need for vasopressors BUN, blood urea nitrogen; PaO2 blood cell. a ) /FiO2, arterial oxygen pressure/fraction of inspired oxygen; WBC, white b A need for noninvasive ventilation can substitute for a respiratory rate >30 breaths/min or a PaO2 ratio < 250. c As a result of infection alone. Other criteria to consider include hypoglycemia (in nondiabetic patients), acute alcoholism/alcoholic withdrawal, hyponatremia, unexplained metabolic acidosis or elevated lactate level, cirrhosis, and asplenia. /FiO2