CURB-65 was an international pneumonia stratification scoring tool derived in the UK, New Zealand, and the Netherlands retrospectively with 1068 patients. 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.
|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|
- BUN > 19 mg/dl
- Respiratory rate > 30
- Systolic blood pressure < 90 mmHg or diastolic blood pressure < 60 mmHg
- Age > 65
- Approximate 30-day mortalities and treatment considerations
- +1 → 3%, outpatient treatment
- +2 →7%, inpatient, possible outpatient
- +3 → 14% inpatient, possible ICU
- +4-5 → 30% ICU
- 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.
- 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.
- 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.