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.
Patient Data
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.