CURB-65 Score - Pneumonia Severity
Assess severity of community-acquired pneumonia using the CURB-65 score to guide treatment and hospital admission decisions.
Important Medical Disclaimer
This calculator is an educational and clinical decision support tool. Results DO NOT replace professional medical evaluation, laboratory tests, or clinical judgment. Always consult a qualified healthcare professional for diagnosis, treatment, and clinical decisions. Calculations are based on scientifically validated formulas but may not be applicable to all patients.
About CURB-65 Score
The CURB-65 score is a clinical prediction rule used to assess the severity of community-acquired pneumonia (CAP) and guide treatment decisions regarding hospitalization. Developed by the British Thoracic Society in 2003, it evaluates 5 prognostic factors.
CURB-65 Criteria (1 point each)
- C - Confusion (new onset)
- U - Urea >7 mmol/L (BUN >19 mg/dL)
- R - Respiratory rate ≥30 breaths/min
- B - Blood pressure: SBP <90 or DBP ≤60 mmHg
- 65 - Age ≥65 years
Score Interpretation & Treatment
- 0-1 points: Low risk (<3% mortality) - Consider outpatient treatment
- 2 points: Moderate risk (9% mortality) - Consider short hospital stay or close outpatient monitoring
- 3-5 points: High risk (15-40% mortality) - Hospital admission required; consider ICU for scores 4-5
Note: CURB-65 is a clinical tool to aid decision-making and should be used alongside clinical judgment. Patients with comorbidities, hypoxemia, or other concerning features may require hospitalization regardless of score.
Frequently Asked Questions
What is the difference between CURB-65 and CRB-65?
CRB-65 is a simplified version that excludes the 'Urea' criterion since laboratory tests may not be available in primary care settings. It uses only 4 criteria (C, R, B, 65) with a score of 0-4. It's useful for initial triage, but the full CURB-65 provides better risk stratification.
Can CURB-65 be used for hospital-acquired pneumonia?
No, CURB-65 was specifically developed for community-acquired pneumonia (CAP). For hospital-acquired or ventilator-associated pneumonia, other scores such as PSI (Pneumonia Severity Index) or APACHE II are more appropriate.
When should I consider ICU admission despite a low CURB-65 score?
Consider ICU admission regardless of score if the patient has: need for mechanical ventilation, septic shock (persistently low blood pressure despite fluids), severe respiratory failure (PaO2/FiO2 <250), rapid deterioration, or complications such as complicated pleural effusion or empyema.
How is confusion defined in CURB-65?
Confusion is defined as new onset disorientation or worsening of pre-existing confusion regarding person, place, or time. It can be assessed using the abbreviated mental test (AMT ≤8 points) or clinical observation of acute disorientation not attributable to another cause (such as pre-existing dementia).