CURB-65 Pneumonia Severity Score
Estimate 30-day mortality risk in community-acquired pneumonia (CAP) to guide clinical disposition (outpatient vs. inpatient admission vs. ICU monitoring).
Clinical Criteria
Select all that apply
Result
CURB-65 Score
0points
Low Risk
0.6% - 2.7% 30-day Mortality Risk
Recommendation
Outpatient Care
Clinical Notes
- Target Population: Patients with community-acquired pneumonia (CAP).
- Estimates mortality of community-acquired pneumonia to help determine inpatient vs. outpatient treatment.
- Confusion, Urea, Respiratory Rate, Blood Pressure, Age 65.
- Source: Lim WS et al. (2003)
About the CURB-65 Score
The CURB-65 score is a clinical prediction rule that validates the severity of community-acquired pneumonia (CAP) and recommends the site of care (home, hospital, or ICU).
Criteria
- Confusion: New mental confusion.
- Urea: Blood Urea Nitrogen (BUN) > 19 mg/dL (> 7 mmol/L).
- Respiratory Rate: ≥ 30 breaths/min.
- Blood Pressure: Systolic < 90 mmHg or Diastolic ≤ 60 mmHg.
- 65: Age ≥ 65 years.
Interpretation & Management
| Score | Risk Group | 30-day Mortality | Recommendation |
|---|---|---|---|
| 0 - 1 | Low | 0.6% - 2.7% | Home treatment (Outpatient) |
| 2 | Moderate | 6.8% | Consider short-stay hospital admission or supervised outpatient care |
| 3 | High | 14.0% | Manage in hospital as severe pneumonia |
| 4 - 5 | High | 27.8% - 57% | Manage in hospital; consider ICU admission |
Primary Literature & Validation Citations
- Derivation & Validation Study: Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377-382. doi:10.1136/thorax.58.5.377.[PubMed PMID: 12728163]
- Clinical Practice Guidelines: Metlay JP, Waterer GW, Long AC, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia: An Official Clinical Practice Guideline of the ATS and IDSA. Am J Respir Crit Care Med. 2019;200(7):e45-e67.
Disclaimer: This tool is intended for educational and reference purposes only. It should not be used as a substitute for professional medical judgment or advice.
Clinically reviewed by Jed Whetten, MD Candidate (Univ. of Arizona COM-Phoenix) • Verified September 2026