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CURB-65
From WikEM
Contents
Background
CURB-65 was an international pneumonia stratification scoring tool derived in the UK, New Zealand, and the Netherlands retrospectively with 1068 patients.[1] Other studies have confirmed mortality increase with increasing scoring. The score does not take into account patient's comorbidities that may also influence disposition location.[2][3]
| CURB-65 score | Morality Risk | Recommendation per Derivation Study |
| 0 | 0.60% | Low risk; consider outpatient treatment |
| 1 | 2.70% | Low risk; consider outpatient treatment |
| 2 | 6.80% | Short inpatient hospitalization or inpatient observation |
| 3 | 14.00% | Severe pneumonia; hospitalize and consider ICU |
| 4 or 5 | 27.80% | Severe pneumonia; hospitalize and strongly consider ICU |
Scoring
- Confusion
- bUn > 19mg/dl
- RR > 30
- BP < 90 SBP, or < 60 DBP
- Age > 65
- Approximate 30-day mortalities and treatment considerations
- +1 → 3%, outpatient treatment
- +2 →7%, inpt, possible outpatient
- +3 → 14% inpt, possible ICU
- +4-5 → 30% ICU
See Also
References
- ↑ W Lim. et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003 May; 58(5): 377–382.
- ↑ Shah BA, et. al. Validity of Pneumonia Severity Index and CURB-65 Severity Scoring Systems in Community Acquired Pneumonia in an Indian Setting. The Indian Journal of Chest Diseases & Allied Sciences. 2010;Vol.52.
- ↑ Aujesky D. et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am. J. Med. 2005;118(4): 384–92.
