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  CURB-65 Pneumonia Severity Score

 
Input
 
Age  
Confusion No (0)

Yes (1)
BUN  
Respiratory Rate  
Systolic Blood Pressure  
Diastolic Blood Pressure  

 
Results
 
 
CURB65 Score  
 

 
     
 
Include literature references: Yes   No

 
  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)

 
 
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 PubMed Logo
  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 PubMed Logo
  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 PubMed Logo
  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 PubMed Logo
  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 PubMed Logo
  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 PubMed Logo

 
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      

 
This material contains content from LOINC® (http://loinc.org). The LOINC table, LOINC codes, and LOINC panels and forms file are copyright © 1995-2014, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

 
Associated ICD10-CM Codes
 
   J12.9Viral pneumonia, unspecified
   J18.1Lobar pneumonia, unspecified organism
   J13Pneumonia due to Streptococcus pneumoniae
   J12.9Viral pneumonia, unspecified
   J11.00Influenza due to unidentified influenza virus with unspecified type of pneumonia
   J15.9Unspecified bacterial pneumonia
   J18.0Bronchopneumonia, unspecified organism

 
Associated ICD9-CM Codes
 
   485Bronchopneumonia org nos
   482.9Bacterial pneumonia nos
   487.0Influenza with pneumonia
   481Pneumococcal pneumonia
   480.9Viral pneumonia nos

 
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