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CURB-65 Severity Score

Evaluate confusion, urea, respiratory rate, blood pressure, and age to estimate mortality risk in community-acquired pneumonia.

Threshold: >7 mmol/L (≈20 mg/dL) adds 1 point.

Results

Confusion

0

New confusion

Urea

0

BUN > 7 mmol/L (20 mg/dL)

Respiratory rate

0

≥30 breaths/min

Blood pressure

0

SBP <90 or DBP ≤60

Age

0

≥65 years

Total CURB-65 score

0

Low risk; consider outpatient treatment.

Risk interpretation:

  • Score 0 – 1: Low risk; consider outpatient treatment.
  • Score 2: Moderate risk; consider short inpatient stay or supervised outpatient.
  • Score 3 – 5: High risk; hospitalize, assess for ICU if score ≥4.

How to Use This Calculator

Ensure patient meets criteria for community-acquired pneumonia via history, physical, and imaging. Record mental status, BUN/urea, respiratory rate, blood pressure, and age; each contributes 0–1 point. Combine CURB-65 score with clinical judgement when deciding outpatient vs inpatient vs ICU care.

Formula

CURB-65 total = Confusion (1) + Urea >7 mmol/L (1) + Respiratory rate ≥30 (1) + Blood pressure (SBP <90 or DBP ≤60) (1) + Age ≥65 (1).

Frequently Asked Questions

Acute mental status change judged by clinician or AMT score ≤8/10. Use clinical judgement to identify new disorientation. Yes—convert to mmol/L when possible. BUN mg/dL × 0.357 ≈ mmol/L. Yes—elderly or comorbid patients may warrant admission even with low CURB-65 scores. CRB-65 excludes urea; use when labs unavailable. Score thresholds remain similar. It was validated for community-acquired pneumonia; use caution in other settings.