Question

A 68-year-old male presents with cough with sputum and bronchial sounds. RR-20/min, urea-44mg/dl, BP-110/70mmHg. What is the next step in management?

• A. Home Rx
• B. Admit in ICU without MV
• C. Admit in ICU with MV
• D. Room admission

Hint:

Calculate the CURB-65 score using the given parameters to determine the appropriate level of care.

Answer 1

The Correct Option is D

CURB-65 scoring system for Community-Acquired Pneumonia:

Clinical data provided: Age 68 yr, RR 20/min, Urea 44 mg/dL, BP 110/70 mmHg, no mention of confusion.

Scoring each parameter:

Parameter	Threshold	Patient value	Score
Confusion (C)	New onset	Not mentioned	0
Urea (U)	>19 mg/dL	44 mg/dL	1
Respiratory Rate (R)	≥30/min	20/min	0
Blood Pressure (B)	SBP <90 or DBP &le;60	110/70 mmHg	0
Age &ge;65 (65)	&ge;65 years	68 years	1

$\text{Total CURB-65 Score} = 0 + 1 + 0 + 0 + 1 = 2$

Score 2 = 9.2% mortality risk = Inpatient (room) admission recommended.

• Score 0-1: Home treatment
• Score 2: Room admission (ward)
• Score ≥3: ICU consideration

\[\boxed{\text{Room admission (Option D)}}\]