CURB-65

Formula

1 point each: confusion; urea above 7 mmol/L; respiratory rate 30 or above; SBP below 90 or DBP 60 or below; age 65 or above. 0-1 low, 2 moderate, 3-5 high severity.

Limitations

• A severity aid, not a substitute for clinical judgement (social factors, oxygenation, comorbidity).
• The 2019 ATS/IDSA guideline preferred the Pneumonia Severity Index over CURB-65 for deciding whether to hospitalise (conditional recommendation); local guidance varies.
• Urea is in mmol/L (UK convention); convert BUN in mg/dL with the conversion helpers.
• The definition of confusion (AMT 8 or below, or new disorientation) is a clinician assessment.

References

1. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Lim WS, van der Eerden MM, Laing R, et al. Thorax. 2003;58(5):377-382. PMID 12728155