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CURB-65 Pneumonia Severity Score

 

Input
 

Age		mo yr
Confusion	No (0) Yes (1)
BUN		mg/dL mmol/L
Respiratory Rate		/min br/min breaths/min
Systolic Blood Pressure		Pascal cmH2O cm[H2O] mm Hg mm/Hg mmHg mm[Hg] torr
Diastolic Blood Pressure		Pascal cmH2O cm[H2O] mm Hg mm/Hg mmHg mm[Hg] torr

 

Results
 
Important: Inputs must be complete to perform calculation.

 

CURB65 Score		# count index logit none number points score [No Unit]

 

CURB-65 Score

 

0 to 1 Point:	Low risk (1.5% mortality)
2 Points:	Intermediate risk (9.2% mortality)
3 to 5 Points:	High risk (22% mortality)

 

 

Data action

 

     
 
Include literature references: Yes   No

 

 

Notes

• Risk group assignment and mortality estimation per Lim article.^[5]
• Confusion is defined by an abbreviated Mental Test Score ≤8 or new loss of orientation to person, place, or time.

 
Equations used
 

CURB65Score = Confusion + BUNFactor + RespiratoryRateFactor + BloodPressureFactor + AgeFactor

 

 

Calculation Details and Variables

• AgeFactor is assigned values by this ordered logic:
  • If Age ≥65 yr, AgeFactor = 1
  • Else AgeFactor = 0.
• Equation parameters such as Confusion, have two or more discrete values that may be used in the calculation. The numbers in the parentheses, e.g. (0), represent the values that will be used.
• BUNFactor is assigned values by this ordered logic:
  • If BUN >19 mg/dL, BUNFactor = 1
  • Else BUNFactor = 0.
• RespiratoryRateFactor is assigned values by this ordered logic:
  • If Respiratory Rate ≥30 breaths/min, RespiratoryRateFactor = 1
  • Else RespiratoryRateFactor = 0.
• If SystolicBloodPressure <90 mmHg or DiastolicBloodPressure ≤60 mmHg, BloodPressureFactor is set to 1. Otherwise BloodPressureFactor is set to 0.

 

References

1. Steinberg DI. ACP Journal Club. Review: Risk prediction scales have different strengths and weaknesses for predicting mortality in community-acquired pneumonia. Ann Intern Med. 2011 Apr 19;154(8):JC4-12. doi: 10.1059/0003-4819-154-8-201104190-02012. PubMed ID: 21502638
2. Loke YK, Kwok CS, Niruban A, Myint PK. Value of severity scales in predicting mortality from community-acquired pneumonia: systematic review and meta-analysis. Thorax. 2010 Oct;65(10):884-90. doi: 10.1136/thx.2009.134072. Epub 2010 Aug 20. Review. PubMed ID: 20729235
3. Morris A. ACP Journal Club. Review: CURB65, CRB65, and Pneumonia Severity Index similarly predict mortality in community-acquired pneumonia. Ann Intern Med. 2011 Apr 19;154(8):JC4-13. doi: 10.1059/0003-4819-154-8-201104190-02013. PubMed ID: 21502639
4. Chalmers JD, Singanayagam A, Akram AR, et al. Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis. Thorax. 2010 Oct;65(10):878-83. doi: 10.1136/thx.2009.133280. Epub 2010 Aug 20. Review. PubMed ID: 20729231
5. 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 May;58(5):377-82. PubMed ID: 12728155
6. Lim WS, Macfarlane JT, Boswell TC, et al. Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines. Thorax. 2001 Apr;56(4):296-301. PubMed ID: 11254821

 

Associated Medical Subject Headings [MeSH]
 

80 and over,   Adolescent,   Adult,   Aged,   Anti-Bacterial Agents,   Bacterial,   Cohort Studies,   Community-Acquired Infections,   Female,   Home Care Services,   Hospitalization,   Humans,   Male,   Middle Aged,   Multivariate Analysis,   Patient Selection,   Pneumonia,   Predictive Value of Tests,   Prognosis,   Prospective Studies,   Regression Analysis,   Severity of Illness Index,   Viral

 

Associated Logical Observation Identifiers Names and Codes [LOINC]
 

Parameter	LOINC's and Suggested Units
Age	21612-7 : yr      21612-7 : yr      21612-7 : years      30525-0 : Years old      30525-0 : yr      30525-0 : years
BUN	3094-0 : mg/dL      6299-2 : mg/dL      14937-7 : mmol/L      59570-2 : mmol/L
Respiratory Rate	9303-9 : breaths/min      9279-1 : breaths/min      76170-0 : breaths/min      19840-8 : breaths/min
Systolic Blood Pressure	8480-6 : mmHg
Diastolic Blood Pressure	8462-4 : mmHg

 
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