Clinical tool
CURB-65
Pneumonia severity score to support site-of-care decisions.
CURB-65
0/ 5
Low severity
Score of 0 or 1. About 1.5% 30-day mortality. Community management is often appropriate when social circumstances allow.
This score supports risk stratification and should be interpreted alongside the overall clinical context and current treatment guidance.
Score support, not a decision
What this calculates
Pneumonia severity: one point each for confusion, urea above 7 mmol/L, respiratory rate of 30 or more, low blood pressure and age 65 or over.
When to use it
At first assessment of community-acquired pneumonia, to help decide the site of care.
How to interpret it
0 to 1 is low severity, 2 moderate and 3 to 5 high. Approximate 30-day mortality is 1.5%, 9% and 22% for those groups.
Important limitations
- It estimates mortality risk, not the need for antibiotics.
- Hypoxia, comorbidity, social circumstances and ability to take oral medication are not in the score and may decide the site of care.
- It performs less well in younger patients and the immunocompromised. CRB-65 omits urea for use without blood results.
For practising medics only. Clinical tools support judgement, they do not replace it. Always verify results against current guidelines and the patient in front of you.