When should you admit a patient with suspected CAP?

Abstract

When the patient has 2 or more of the following CURB-65 criteria: respiratory rate ≥30, acute confusion, low blood pressure (systolic blood pressure <90 or diastolic BP ≤60 mm H g), blood urea nitrogen [BUN ] >19.6 mg/dL, and age ≥65 years (strength of recommendation [SOR]: B, based on 3 prospective cohort studies). Alternatively, consider hospitalization for patients presenting with a Pneumonia Severity Index (PSI) class of 4 or 5 (SOR: B; 1 prospective cohort study). There are no studies that test whether using these rules improve outcomes over standard care.