Assess community-acquired pneumonia severity using the CURB-65 score. Evaluate five clinical criteria to determine appropriate treatment setting — outpatient, short hospitalization, or inpatient care.
Each criterion checked adds 1 point to the CURB-65 score (range: 0–5).
A 45-year-old female with community-acquired pneumonia presents with no confusion, normal urea (5.2 mmol/L), respiratory rate 18/min, BP 128/82 mmHg, and age 45.
CURB-65 Score: 0
Interpretation: Low severity. Suitable for outpatient treatment with oral antibiotics. Mortality risk < 1%.
A 68-year-old male presents with no confusion, urea 8.5 mmol/L, respiratory rate 32/min, BP 105/68 mmHg, and age 68.
Criteria met: Urea > 7 mmol/L (1) + Respiratory Rate ≥ 30 (1) = Score 2
Interpretation: Moderate severity. Consider short hospitalization or closely monitored outpatient care. Mortality risk ~9%.
An 82-year-old female with pneumonia presents acutely confused, urea 11.2 mmol/L, respiratory rate 34/min, BP 88/56 mmHg, and age 82.
Criteria met: Confusion (1) + Urea > 7 mmol/L (1) + RR ≥ 30 (1) + BP hypotension (1) + Age ≥ 65 (1) = Score 5
Interpretation: Severe pneumonia. Immediate hospitalization, likely ICU admission. Mortality risk > 40%.
A 55-year-old male presents with confusion, urea 9.0 mmol/L, respiratory rate 28/min, BP 85/50 mmHg, and age 55.
Criteria met: Confusion (1) + Urea > 7 mmol/L (1) + BP hypotension (1) = Score 3
Interpretation: Severe pneumonia. Hospital admission required. Mortality risk ~15–20%.
The CURB-65 score is a validated clinical prediction tool used to assess the severity of community-acquired pneumonia (CAP). It helps clinicians determine whether a patient can be treated as an outpatient or requires hospitalization. The score was developed from the British Thoracic Society's CURB criteria and later modified to include age (65).
| Letter | Criterion | Threshold | Points |
|---|---|---|---|
| C | Confusion | New onset confusion, AMTS ≤ 8, or disorientation | 1 |
| U | Urea | Blood urea > 7 mmol/L (≈ 20 mg/dL) | 1 |
| R | Respiratory Rate | ≥ 30 breaths per minute | 1 |
| B | Blood Pressure | SBP < 90 mmHg OR DBP ≤ 60 mmHg | 1 |
| 65 | Age ≥ 65 | Patient aged 65 years or older | 1 |
| Score | Risk Group | 30-Day Mortality | Recommended Management |
|---|---|---|---|
| 0–1 | Low | < 1–3% | Outpatient treatment with oral antibiotics |
| 2 | Moderate | ~9% | Short hospitalization or closely monitored outpatient care |
| 3–5 | Severe | 15–40%+ | Hospitalize (consider ICU for scores 4–5) |
The CURB-65 score is a validated clinical prediction rule for community-acquired pneumonia (CAP) severity, developed by the British Thoracic Society. The acronym stands for: Confusion, Urea (> 7 mmol/L), Respiratory rate (≥ 30/min), Blood pressure (hypotension), and age 65 (≥ 65 years).
Each criterion is 1 point (score 0–5), stratifying patients into low (0–1), moderate (2), and severe (3–5) risk categories with corresponding management recommendations and 30-day mortality estimates. The score is recommended by the British Thoracic Society, IDSA, and ATS for CAP management.
The CURB-65 score does not account for comorbidities (lung disease, heart failure, diabetes), immunosuppression, oxygen saturation, or chest X-ray findings. Clinical judgment should always complement the score, particularly in borderline cases or patients with complex histories.
The CURB-65 score helps answer: "Does this patient need to be in the hospital?" — for use in EDs, primary care, and admissions.
Treat at home with oral antibiotics. Provide clear return instructions. Follow-up within 24–48 hours recommended.
May benefit from short stay (24–48 hours) for observation and parenteral antibiotics. Transition to oral when stable.
Severe pneumonia requiring hospital admission. Scores 4–5 may require ICU-level care, respiratory support, and vasopressors.
Clinical status should be reassessed regularly. Deterioration may require escalation regardless of initial CURB-65 score.
⚠️ Important Medical Disclaimer: This CURB-65 Calculator is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. The CURB-65 score should be used as a decision aid alongside comprehensive clinical assessment. Always consult a qualified healthcare provider with any questions about pneumonia diagnosis and management. Do not make treatment decisions based solely on the results from this calculator.