Pneumonia severity and mortality risk
Total Score
Low risk (mortality 1.5%). Consider outpatient treatment.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Yasal Uyarı: Bu platformdaki klinik skorlamalar ve algoritmalar yalnızca sağlık profesyonellerini bilgilendirme amaçlıdır. Herhangi bir kesin tıbbi teşhis, tedavi veya klinik karar yerine geçemez. Nihai karar ve sorumluluk hastayı yatak başında değerlendiren hekime aittir.
The CURB-65 score is a widely validated clinical prediction rule used to estimate mortality in patients with community-acquired pneumonia (CAP). By evaluating Confusion, Urea, Respiratory rate, Blood pressure, and Age (≥65), it effectively guides the clinical decision of whether a patient safely qualifies for outpatient treatment or requires hospitalization/ICU admission.
In the United States, Blood Urea Nitrogen (BUN) is typically measured rather than urea. A BUN > 19 mg/dL is roughly equivalent to a Urea > 7 mmol/L. Do not use CURB-65 for healthcare-associated or ventilator-associated pneumonia.
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.
Disclaimer: The clinical scoring and algorithms on this platform are intended strictly for professional informational purposes. They do not constitute a definitive medical diagnosis, treatment, or clinical decision. The final judgment and responsibility lie with the treating physician.
Apply CURB-65 to adult patients with community-acquired pneumonia (CAP) to guide site-of-care decisions. Score 0–1: outpatient antibiotic therapy is appropriate if the patient can tolerate oral medication and reliable follow-up is ensured. Score 2: hospital admission for IV antibiotics and monitoring. Score 3–5: severe CAP requiring hospital admission; consider ICU for scores ≥ 3, especially if accompanied by bilateral consolidation, multilobar involvement, or hypoxaemia. For immunocompromised patients, apply a lower threshold for admission than the score alone suggests.
When BUN testing is not immediately available (e.g., initial triage), the CRB-65 variant (omitting the urea criterion) provides a validated 4-point alternative. A CRB-65 score of 0 reliably identifies a low-risk outpatient group. For older patients, the "confusion" criterion is particularly powerful — even a single episode of new acute confusion in a patient with CAP is a strong indicator of severe physiological derangement that should prompt early IV therapy and hospital monitoring regardless of the total score.
CURB-65 focuses exclusively on short-term mortality risk and does not capture several important clinical dimensions that influence admission decisions: oxygen saturation (SpO₂ < 92% on room air is itself an indicator of severe disease not captured in the score), bilateral or multilobar infiltrates, pleural effusion, inability to maintain oral intake, and lack of safe home environment. Always supplement CURB-65 with clinical gestalt and local guideline thresholds — a score of 1 in a patient with SpO₂ 88% and bilateral consolidation should not be managed as outpatient.