CURB65 Pneumonia Severity Score Calculator

CURB65 Pneumonia Severity Score Explanation and Clinical Context
CURB65 assigns one point for each of five readily available clinical variables at initial assessment: new onset confusion, blood urea greater than 7 mmol per liter, respiratory rate of 30 breaths per minute or more, low blood pressure defined as systolic less than 90 mm Hg or diastolic 60 mm Hg or less, and age 65 years or older. The total score ranges from 0 to 5 and stratifies patients by increasing risk of mortality. Scores of 0 identify patients at low risk who may be suitable for outpatient management. Scores of 1 and 2 correspond to low to moderate risk and often require clinical judgement about admission versus outpatient care. Scores of 3 or more are associated with substantially higher mortality and generally warrant hospital admission and consideration of higher level care. This tool supports but does not replace clinical judgement and local pathways should be followed when deciding site of care and level of monitoring.

Reference
Lim WS et al. Defining community acquired pneumonia severity on presentation to hospital an international derivation and validation study. 2003. PubMed listing and original description of the CURB65 rule.
NICE guidance on pneumonia recommends use of CURB65 to aid decision making on site of care.
BMJ Best Practice summary of CURB65 criteria and thresholds.
MDCalc practical calculator and bedside implementation notes.
Radiopaedia concise criteria summary.

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