CURB-65

Background

CURB-65 was an international pneumonia stratification scoring tool derived in the UK, New Zealand, and the Netherlands retrospectively with 1068 patients.[1] Other studies have confirmed mortality increase with increasing scoring. The score does not take into account patient's comorbidities that may also influence disposition location.[2][3]

CURB-65 score Morality Risk Recommendation per Derivation Study
0 0.60% Low risk; consider outpatient treatment
1 2.70% Low risk; consider outpatient treatment
2 6.80% Short inpatient hospitalization or inpatient observation
3 14.00% Severe pneumonia; hospitalize and consider ICU
4 or 5 27.80% Severe pneumonia; hospitalize and strongly consider ICU

Scoring

  1. Confusion
  2. bUn > 19mg/dl
  3. RR > 30
  4. BP < 90 SBP, or < 60 DBP
  5. Age > 65
  • Approximate 30-day mortalities and treatment considerations
    • +1 → 3%, outpatient treatment
    • +2 →7%, inpt, possible outpatient
    • +3 → 14% inpt, possible ICU
    • +4-5 → 30% ICU

See Also

References

  1. W Lim. et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003 May; 58(5): 377–382.
  2. Shah BA, et. al. Validity of Pneumonia Severity Index and CURB-65 Severity Scoring Systems in Community Acquired Pneumonia in an Indian Setting. The Indian Journal of Chest Diseases & Allied Sciences. 2010;Vol.52.
  3. Aujesky D. et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am. J. Med. 2005;118(4): 384–92.