CRB-65: Predictor for Intensive Care Unit Admission in Patients with Biliary Tract Infection Presenting to An Emergency Department

Objectives: Biliary tract infection (BTI) is a common cause of bacteremia and is associated with high morbidity and mortality. However, studies on screening tools to predict disease severity in BTI patients are lacking. This study aimed to comparatively validate CRB, CRB-65, quick Sequential Organ Failure Assessment (qSOFA), and Systemic Inflammatory Response Syndrome (SIRS) in predicting the clinical outcomes of BTI patients. Methods: This retrospective cohort study included patients with BTI who visited the emergency department of a medical center between February 2018 and March 2020. Baseline patient data were compared to assess the prevalence of intensive care unit (ICU) admission and in-hospital mortality. The effectiveness of CRB, CRB-65, qSOFA, and SIRS scores as indicators of ICU admission and in-hospital mortality was evaluated using the area under the receiver operating characteristic (AUROC) curve. Results: This study included 745 patients, of whom 111 (14.8%) were admitted to the ICU and 20 (2.7%) died in-hospital. AUROC values (95% CI) for predicting ICU admission and in-hospital mortality were as follows: CRB, 0.774 and 0.707 (0.742 –0.803 and 0.673 – 0.739); CRB - 65, 0.816 and 0.735 (0.786 – 0.843 and 0.0.702 – 0.766); qSOFA, 0.779 and 0.724 (03747 – 0.808 and 0.690 – 0.755); and SIRS, 0.686 and 0.659 (0.651 – 0.719 and 0.623 – 0.693), respectively. Conclusions: CRB-65 can be used as useful screening tools to predict ICU admission in patients with BTI on presentation to the emergency department.

Biliary tract infection, Emergency department, CRB-65, CRB, Quick Sequential Organ Failure Assessment

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