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CURB-65 score for pneumonia severity

Mortality risk and site-of-care decision in community-acquired pneumonia.

CURB-65 score for pneumonia severity
Confusion (new disorientation)
Urea >7 mmol/L (BUN >19 mg/dL)
Respiratory rate ≥30 /min
SBP <90 or DBP ≤60 mmHg
Age ≥65 years
Result0 points

Low severity — outpatient treatment usually appropriate. 30-day mortality ≈ 0.6 %.

30-day mortality
0.6 %

When to use

  • Estimating mortality and guiding admission versus outpatient management in community-acquired pneumonia.

Formula

One point each for Confusion, Urea >7 mmol/L, Respiratory rate ≥30, low Blood pressure (SBP <90 or DBP ≤60), and age ≥65. Range 0–5.

Pearls and pitfalls

  • CRB-65 omits urea for use where bloods are unavailable (e.g. primary care). Both are decision aids that support, not replace, clinical judgement.

References

  1. Lim WS, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377–82.