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CURB-65 Score
Estimates 30-day mortality risk in patients with community-acquired pneumonia (CAP) and supports hospital admission/ICU decisions.
Confusion
AMTS score ≤ 8 or disorientation to person, place, or time
Urea (BUN)
Serum Urea > 42.8 mg/dL (BUN > 19 mg/dL or > 7 mmol/L)
Respiratory Rate
Respiratory rate ≥ 30 breaths/min
Blood Pressure
Systolic < 90 mmHg OR Diastolic ≤ 60 mmHg
Age (≥ 65)
Is the patient 65 years or older?
0
Points
Loading Risk…
30-Day Mortality: -%
| Score | Risk Group | Recommended Action |
|---|---|---|
| 0 – 1 | Low Risk | Consider home treatment (Safe for discharge) |
| 2 | Moderate Risk | Short inpatient hospitalization or closely supervised outpatient treatment |
| 3 – 5 | High Risk | Severe pneumonia; hospitalize and consider admitting to intensive care |
1
Comorbidity Gap: CURB-65 does not directly assess major comorbidities like COPD, heart failure, or immunosuppression. Low-scoring patients with severe comorbidities may still require admission.
2
Ignores Oxygenation: The score does not include SpO2 or pO2. Discharging a hypoxemic patient solely based on a low CURB-65 score is a major clinical error.
3
Young Patient Fallacy: Young patients (e.g., 30 years old) usually score low (0 or 1). However, if severe pneumonia symptoms are present, clinical judgment always supersedes the score.
4
CRB-65 Alternative: If Urea (BUN) cannot be checked in primary care, the CRB-65 score, which does not require lab tests, can be used.
