CURB65 score for mortality risk assessment of community acquired pneumonia (CAP) when assessed in hospital setting

CURB65 score for mortality risk assessment in hospital (1, 2)

• CURB65 score is calculated by giving 1 point for each of the following prognostic features:
  • confusion (abbreviated Mental Test score 8 or less, or new disorientation in person, place or time)
  • raised blood urea nitrogen (over 7 mmol/litre)
  • raised respiratory rate (30 breaths per minute or more)
  • low blood pressure (diastolic 60 mmHg or less, or systolic less than 90 mmHg)
  • age 65 years or more

Patients are stratified for risk of death as follows:

• 0 or 1: low risk (less than 3% mortality risk)
• 2: intermediate risk (3-15% mortality risk)
• 3 to 5: high risk (more than 15% mortality risk)

Use clinical judgement in conjunction with the CURB65 score to guide the management of community-acquired pneumonia, as follows:

• consider home-based care for patients with a CURB65 score of 0 or 1
• consider hospital-based care for patients with a CURB65 score of 2 or more
• consider intensive care assessment for patients with a CURB65 score of 3 or more

Reference:

1. National Institute for Health and Care Excellence. Pneumonia in adults: diagnosis and management. July 2022 [internet publication].
2. British Thoracic Society. 2015 - Annotated BTS guideline for the management of CAP in adults (2009) summary of recommendations. Jan 2015