What goes into the CURB-65
- Confusion (new) (+1)
- BUN > 19 mg/dL (urea > 7 mmol/L) (+1)
- Respiratory rate ≥ 30 (+1)
- SBP < 90 or DBP ≤ 60 mmHg (+1)
- Age ≥ 65 (+1)
How to interpret the result
- 0–1: low risk (30-day mortality about 1–3%); outpatient treatment is usually appropriate
- 2: moderate risk (about 9%); short admission or closely supervised outpatient care
- 3–5: high risk (15–40%); admit, and assess for ICU care at 4–5
Clinical pearls
- The 2019 ATS/IDSA CAP guideline prefers the Pneumonia Severity Index (PSI) for US site-of-care decisions; CURB-65 is faster at the bedside.
- Hypoxemia, inability to take oral medication or an unsafe home situation justify admission at any score.
- Use the ATS/IDSA major and minor criteria, not CURB-65, to decide on ICU admission.
Evidence
- Lim WS, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58:377-382.
Related workups
Related calculators
For education only. Check the inputs and the population the score was validated in before acting on it. Not a substitute for clinical judgment.