Association between Serum CRP Level and CURB-65 Score in Community Acquired Pneumonia Patients

Community acquired pneumonia (CAP) is major cause of morbidity and mortality in adults. The presentation may be varied. In addition, there are some non-infectious respiratory diseases in the differential diagnosis of CAP, such as malignant diseases, interstitial lung diseases, pulmonary edema, and pulmonary hemorrhage. We usually diagnose patients having CAP by comprehensive evaluation of symptoms, vital signs, laboratory examinations, and radiographic examinations. Several severity scores have been proposed to predict patient outcome and to guide initial management of patients with community acquired pneumonia (CAP). Most have been derived as predictors of mortality and CURB-65 (confusion, blood urea nitrogen, respiratory rate, blood pressure and age 65) is commonly used score. To assess the association between serum CRP level and CURB-65 score among patients with community acquired pneumonia cross sectional study was done. A total of 101 consecutive adult patients of either sex admitted in Bir Hospital with the diagnosis of CAP were enrolled. CURB-65 score and serum CRP level were calculated. Data analysis was done using SPSS. A p value <0.05 was considered statistically significant. A total of 101 participants (58 male and 47 females) with maximum age of 92 years and minimum age of 23 years were enrolled. Maximum number of patients were of 61-70 years of age group. Maximum number of patients presented with cough, fever, shortness of breath, pleuritic chest pain, sputum production. Patients enrolled in this study, maximum was of CURB-65 one i.e. 47 and least of CURB-65 five i.e. 5. According to CURB-65 score 1,2,3,4,5 mean Serum CRP level was 27.95, 56.36, 71.79, 77.57, 86.18 respectively. There was a statistically significant association between CURB-65 criteria and serum CRP levels (P=0.000345) which means that the concentration of this inflammatory biomarker increased with an increase in the score of CURB-65 criteria. Mortality in this study was 5.45%. According to the results, the serum level of CRP is a strong prognostic factor for evaluating severity of CAP and suitable factor for the CURB-65 criteria in decision making of whether a patient with CAP in the ICU should be admitted.