CURB-65 and CRB-65 Severity Scores for Community-Acquired Pneumonia (CAP)

CURB and CRB-65 scores can be used in the hospital and out-patients setting to assess pneumonia severity and the risk of death.

Clinical factor

Points

Confusion

1

Blood urea nitrogen > 19 mg per dL

1

Respiratory rate > 30 breaths per minute

1

Systolic blood pressure < 90 mm Hg

or

Diastolic blood pressure < 60 mm Hg

1

Age > 65 years

1

Total points:

CURB-65 score

Mortality (%)

Recommendation

0

0.6

Low risk; consider home treatment

1

2.7

2

6.8

Short inpatient hospitalization or closely supervised outpatient treatment

3

14.0

Severe pneumonia; hospitalize and consider admitting to intensive care

4 or 5

27.8

CRB-65 score

Mortality (%)

Recommendation

0

0.9

Very low risk of death; usually does not require hospitalization

1

5.2

Increased risk of death; consider hospitalization

2

12.0

3 or 4

31.2

High risk of death; urgent hospitalization

CURB-65 = Confusion, Urea nitrogen, Respiratory rate, Blood pressure, 65 years of age and older.

CRB-65 = Confusion, Respiratory rate, Blood pressure, 65 years of age and older.

 

References:

  1. Aujesky D, Auble TE, Yealy DM, Stone RA, Obrosky DS, Meehan TP, Graff LG, Fine JM, Fine MJ. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am J Med. 2005 Apr;118(4):384-92. [Medline]

  2. Lim WS, van der Eerden MM, Laing R, Boersma WG, Karalus N, Town GI, Lewis SA, Macfarlane JT. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003 May;58(5):377-82. [Medline]

Created: Mar 20, 2007

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