CURB-65 Score for Pneumonia Severity

CURB-65 Score for Pneumonia Severity

Predicts mortality and guides site-of-care decisions in pneumonia

CURB-65 Score for Pneumonia Severity

CURB-65 Score for Pneumonia Severity

Predicts mortality and guides site-of-care decisions in pneumonia

Patient & criteria
Five 1-point items: Confusion, Urea/BUN, RR, BP, Age ≥65. Sum 0–5 for risk band.
Urea/BUN criterion: Not met
RR criterion: Not met
BP criterion: Not met
Age criterion: ≥65 — Positive
CURB-65 1Low risk
Consider outpatient management if safe and appropriate. · Criteria: c · u · r · b · 65

Instructions

The CURB-65 Score helps estimate mortality risk in community-acquired pneumonia and guides hospitalization decisions. Assign 1 point for each criterion:

  1. Confusion – new onset, disorientation to person, place, or time

  2. Urea > 7 mmol/L (BUN > 20 mg/dL)

  3. Respiratory rate ≥ 30/min

  4. Blood pressure – systolic < 90 mmHg or diastolic ≤ 60 mmHg

  5. Age ≥ 65 years

Overview
When to use
Why use
Evidences

CURB-65 Score

Interpretation

0-1

Low risk

2

Moderate risk

3-5

High risk

 

  • Validation and electronic adaptation: U.S. ED validation and EMR-based modeling confirmed CURB-65 elements and explored continuous weighting to enhance accuracy, supporting its role in practical severity assessment.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3198487/

  • Comparative performance: Reviews and cohort studies note higher mortality in CURB-65 scores 3–5 vs 0–2, and compare specificity and sensitivity trade-offs with PSI, supporting targeted use of CURB-65 in routine practice.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4303164/

Overview
When to use
Why use
Evidences

The CURB-65 Score is a validated clinical prediction tool designed to assess the severity of community-acquired pneumonia (CAP) and estimate 30-day mortality risk. Developed from the British Thoracic Society (BTS) criteria, it incorporates five easily measured parameters: confusion, blood urea nitrogen, respiratory rate, blood pressure, and age. The simplicity of the score allows for rapid bedside assessment in any clinical setting, including emergency departments, primary care, and field environments. It is especially useful for triaging patients, determining the need for hospitalization, and identifying those who may require ICU admission. While highly practical, CURB-65 should be interpreted alongside clinical judgment, comorbidities, and social factors. Limitations include reduced sensitivity in younger patients and in atypical pneumonia presentations.

Overview
When to use
Why use
Evidences

CURB-65 Score

Interpretation

0-1

Low risk

2

Moderate risk

3-5

High risk

 

  • Validation and electronic adaptation: U.S. ED validation and EMR-based modeling confirmed CURB-65 elements and explored continuous weighting to enhance accuracy, supporting its role in practical severity assessment.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3198487/

  • Comparative performance: Reviews and cohort studies note higher mortality in CURB-65 scores 3–5 vs 0–2, and compare specificity and sensitivity trade-offs with PSI, supporting targeted use of CURB-65 in routine practice.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4303164/

Frequently Asked Questions

Features and Services FAQs

Discover the full range of features and services we offer and how to use them.

What is the normal range for a CURB-65 score?+
Does CURB-65 apply to hospital-acquired pneumonia?+
What is the difference between CURB-65 and CRB-65?+
Can CURB-65 be used in children?+
Is CURB-65 better than PSI (Pneumonia Severity Index)?+
How quickly should the score be calculated after presentation?+

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