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

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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