Respiratory & Critical CareEvidence-Based Golden Standard
CURB-65 Pneumonia Severity Score
Stratifies community-acquired pneumonia mortality risk to guide outpatient vs inpatient vs ICU disposition. Each letter is 1 point.
CURB-65 (each = 1 point): Confusion (new AMT ≤8) · Urea >7 mmol/L (BUN >19 mg/dL) · RR ≥30 · BP (SBP <90 or DBP ≤60) · Age ≥65
0–1 low (1.5% mortality, outpatient) · 2 moderate (9.2%, consider admit) · ≥3 severe (22% mortality, urgent admission, assess ICU)
Published Clinical Benchmark Cases
Clinical Parameters & Inputs
Unit: mg/dL
mg/dL
Unit: mmHg
mmHg
Unit: mmHg
mmHg
Computed OutputLow Risk (Score 0)
0points
Diagnostic Interpretation
CURB-65 is 0 (Low Risk, ~1.5% 30-day mortality). Community management with oral antibiotics is usually appropriate; confirm safe home support and 48-hour review.
Calculation Breakdown
Criteria Met
none =0 point(s)
Risk Band
0–1 low · 2 moderate · ≥3 severe =Low Risk (Score 0)
Clinical Decision Pearls
- CURB-65 deliberately excludes oxygenation, so use CRB-65 (no BUN) in the community and add SpO₂/PaO₂ and lactate clinically for ICU triage.
- A score ≥3 warrants senior review and sepsis-screen regardless of disposition.
Limitations & Confounders
- Does not capture comorbidity, hypoxia, or social factors — clinical judgement can override.
- Validated in adults; CRB-65 omitting BUN is preferred where labs are unavailable.
Evidence & Citations
- Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital. Thorax. 2003;58(5):377-382.