External validation in 456 patients with health care-associated pneumonia (HCAP)
The performance of the expanded-CURB was evaluated in a prospective validation cohort of 1164 adult patients with pneumonia hospitalized in a 1200 bed teaching hospital (Policlinico Umberto I-Rome) from Italy. Of these patients, a total of 456 (39.5%) had health care-associated pneumonia (HCAP).

Model performance was confirmed in all HCAP patients of the validation cohort (AUC 0.736, 95% CI, 0.687–0.784). There were no significant differences in term of AUCs between the main cohort and the validation cohort.

Using the Hosmer-Lemeshow test, it was found that expanded-CURB-65 is not validated on HCAP patients (P = 0.0175 after Bonferroni correction).
Validation study authors: Liu JL, Xu F, Zhou H, Wu XJ, Shi LX, Lu RQ, Farcomeni A, Venditti M, Zhao YL, Luo SY, Dong XJ, and Falcone M.
Validation author
Revision date
MeSH terms
  • Pneumonia
  • Community Acquired Infections
  • Mortality
  • Clinical Prediction Rule
  • Validation Studies
  • Hospital Acquired Condition
  • Status


    Rows included 0
    C-index 0.74
    Brier score Not specified
    Scaled Brier score Not specified
    ROC Plot:


    Regression coefficient Not specified
    Intercept Not specified
    Hosmer-Lemeshow GOF < 0.001
    Calibration plot:
    Not specified


    Not specified

    Decision curve

    Not specified
    Original study population: 1640
    Validation study population: 456

    Categorical characteristics

    Name Subset / Group Nr. of patients Validation P-Value
    Age ≥65 years 881 Not reported Not available
    <65 years 759 Not reported
    Cormorbidities Congestive heart failure 164 Not reported Not available
    COPD 136 Not reported
    Chronic renal diseases 83 Not reported
    Chronic liver diseases 41 Not reported
    Cerebrovascular diseases 109 Not reported
    Malignancy 75 Not reported
    Diabetes mellitus 130 Not reported
    Physical examination findings Confusion 85 Not reported Not available
    Respiratory rate ≥30/min 39 Not reported
    Heart rate ≥125/min 36 Not reported
    Hypotension SBP <90 mmHg or DPB <60 mmHg 127 Not reported Not available
    30-day mortality Dead 139 Not reported Not available
    Alive 1501 Not reported

    Continuous characteristics

    Name Mean SD Unit Plot
    Age 64

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    Related validations
    External validation in 704 patients with community-acquired pneumonia (CAP)

    Validation cohort size: 704

    C-Index: Not specified

    Validation study authors: Liu JL, Xu F, Zhou H, Wu XJ, Shi LX, Lu RQ, Farcomeni A, Venditti M, Zhao YL, Luo SY, Dong XJ, and Falcone M.

    Validation author: Evidencio Community

    Revision date: 2017-11-19

    ROC Plot