CURB-65 and CRB-65 Score

CURB-65 or CRB-65 is an acronym used to estimate the severity of community-acquired pneumonia. The parameters considered are Confusion, Blood Urea Nitrogen (BUN, optional), Respiratory rate, Blood pressure, and Age (≥ 65 years). The CRB-65 score omits BUN, but the sensitivity is still comparable to that of the CURB-65 score.

Confusion
Elevated blood urea nitrogen (BUN)
BUN > 7 mmol/l or > 19 mg/dl
Tachypnea
Respiratory rate ≥ 30/min
Hypotension
Blood pressure systolic < 90 mmHg or diastolic ≤ 60 mmHg
Age ≥ 65 years

Score:

30-day mortality:

Interpretation
CURB-65 score 30-day mortality Recommendation
0 0.6 % Outpatient treatment possible
1 2.7 %
2 6.8 % Admission recommended
3 14 % Admission with intensive medical care recommended
4-5 27.8 %
CRB-65 Score 30-day mortality Recommendation
0 0.9 % Outpatient treatment possible
1 5.2 % Admission recommended
2 12 %
3-4 31.2 % Admission with intensive medical care recommended
References
  1. 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: 377-382
  2. Aujesky D, Auble TE, Yealy DM et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am J Med 2005; 118: 384-392

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