CURB-65 Score for Pneumonia Severity
Assesses the severity of community-acquired pneumonia to help guide management decisions, such as the site of care (outpatient vs. inpatient).
Medical Specialty:
Pulmonology
FOR PROFESSIONAL USE ONLY
This calculator is a support tool intended exclusively for health professionals. It does not replace clinical judgment. The final decision regarding diagnosis and treatment is the sole responsibility of the professional.
About this Calculator 💡
CURB-65 is an acronym and a validated clinical prediction rule used to assess the severity of community-acquired pneumonia (CAP) and, crucially, to stratify the 30-day short-term mortality risk. This tool helps clinicians make objective decisions regarding the patient's site of care, i.e., whether outpatient treatment is safe, if hospital admission to a ward is necessary, or if the patient requires intensive care (ICU). The name CURB-65 represents its five assessment components, assigning +1 point for each of the following risk factors:Confusion (defined by an abbreviated mental test score of 8 or less, or new disorientation in person, time, or place);Urea (serum level > 7 mmol/L or 42 mg/dL, or BUN > 19 mg/dL);Respiratory rate (≥ 30 breaths per minute);Blood pressure (low) (systolic < 90 mmHg or diastolic ≤ 60 mmHg); and age (age)65years or older. The total score ranges from 0 to 5. Lower scores (0-1) generally indicate a low mortality risk, suggesting outpatient treatment may be appropriate. A score of 2 suggests increased risk, indicating hospital admission should be considered. Scores of 3 or more are associated with a high mortality risk, warranting urgent hospitalization and strong consideration for ICU admission, especially with scores of 4 or 5.
Reference Values
- •Score 0-1: Low risk (mortality < 3%). Consider outpatient treatment.
- •Score 2: Moderate risk (mortality 9%). Consider hospital admission.
- •Score 3-5: High risk (mortality 15-40%). Urgent hospital admission required; consider ICU.
Formula
Calculation Methodology 1 point for each criterion: Confusion, Urea > 7 mmol/L, Respiratory rate ≥ 30, low Blood pressure, Age ≥ 65.
Reference
Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377-382.