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Respiratory

CURB-65

Community-acquired pneumonia severity score — guides admission vs outpatient decision.

When to use: Assess severity of community-acquired pneumonia (CAP) at presentation to guide site-of-care decisions. Score 0–1 can be managed as outpatient; score ≥3 warrants ICU consideration.
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Formula
CURB-65 = C (Confusion) + U (Urea >7) + R (RR ≥30) + B (BP low) + 65 (Age ≥65) 30-day mortality: 0–1: 1.5%, 2: 9.2%, 3: 22%, 4–5: 57%
Key Points for NEET PG
  • CRB-65 (no urea) is used in outpatient/GP setting where blood tests unavailable
  • CURB-65 ≥3: 30-day mortality 22%; score 4–5: up to 57% mortality
  • PSI (PORT score) is more accurate than CURB-65 but more complex — used in research settings
  • Most common CAP pathogen: Streptococcus pneumoniae regardless of severity
  • Atypical organisms (Mycoplasma, Chlamydophila, Legionella) account for ~20% of CAP
References
Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study · Thorax (2003)
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