Comparative study of CURB-65 and expanded CURB-65 score in community acquired pneumonia in a tertiary care hospital of Assam

Parag Kumar Das, Jayanta Dhekial Phukan, Suresh Sharma, Debasish Goswami, Atovili K. Yepthomi


Background: Community acquired pneumonia is one of the leading causes of morbidity and mortality in developing countries like India. The presentation of CAP may range from mild pneumonia characterized only by fever and productive cough to severe pneumonia leading to respiratory distress and sepsis syndrome requiring management in ICU. Any delay in ICU admission has been shown to be associated with increased mortality. This study was conducted to compare Expanded CURB-65 with CURB-65 scoring system in a tertiary care centre in Assam for early stratification of patients with CAP based of severity and expected prognosis.

Methods: This hospital based prospective study was conducted between September 2020 to August 2021, and a total of 100 patients were taken and followed up form admission to up to 30 days. CURB65 and expanded CURB 65 score was calculated for each patient and the accuracy of each score was statistically compared.

Results: In our study out of 100 patients mean age of 60±17.97 with Mortality rate of 16%. Total 29% patients were need ICU care. The Sensitivity, Specificity, PPV and NPV for predicting mortality and for ICU admission of Expanded CURB-65 score is found to be superior to CURB-65 Score.

Conclusions: In comparison to the CURB-65 score system, the expanded CURB-65 score prioritises both clinical and laboratory criteria and is a more reliable marker for evaluating CAP severity and may improve the effectiveness of forecasting death in CAP patients.


CURB-65, Expanded CURB-65, CAP, ICU, Mortality

Full Text:



Seaton A, Leitch AG, Seaton D. Crofton And Douglas's Respiratory Diseases. John Wiley & Sons. 2008;30.

Garibaldi RA. Epidemiology of community-acquired respiratory tract infections in adults: incidence, etiology, and impact. Am J Med. 1985;28:78:32-7.

Bartlett, J. Treatment of Community-Acquired Pneumonia. Chemotherapy. 2000;46:24-31.

Farooqui H, Jit M, Heymann DL, Zodpey S. Burden of severe pneumonia, pneumococcal pneumonia and pneumonia deaths in Indian states: modelling based estimates. Plos One. 2015;10(6):e0129191.

Prasad P, Bhat S. Clinico microbiological study of community acquired pneumonia. Lung India. 2017;34:491-2.

Fine MJ, Auble TE, Yealy DM, Hanusa BH, Weissfeld LA, Singer DE, et al. A prediction rule to identify low risk patients with community acquired pneumonia. N Engl J Med. 1997;336:243-50.

Lim WS, Van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58:377-82.

Liu JL, Xu F, Zhou H, Wu XJ, Shi LX, Lu RQ et al. Expanded CURB-65: a new score system predicts severity of community-acquired pneumonia with superior efficiency. Sci. Rep. 2016;6:1-8.

Shehata SM, Sileem AE, Shahien NE. Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community- acquired pneumonia in Zagazig University Hospitals. Egypt J Chest Dis Tuberc. 2017;66:549-55.

Mitra D, Roy U, Sinha AK. A comparative study of CURB-65 and expanded CURB-65 scoring systems in community acquired pneumonia in a tertiary care centre of Patna. J Evid Based Med Healthc. 2021;8:1074-8.

Dey AB, Nagarkar KM, Kumar V. Clinical presentation and predictors of outcome in adult patients with community acquired pneumonia. Natl Med J India. 1997;10:4

Madhu S, Augustine S, Kumar RYS, Kauser MM, Kumar VSR, Jayaraju BS et al. Comparative study of CURB-65, Pneumonia Severity Index and IDSA/ATS scoring systems in community acquired pneumonia in an Indian tertiary care setting. Int J Adv Med. 2017;4:693-700.