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CURB-65 (Pneumonia)

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Confusion
No   0 Yes  +1
Urea > 7mmol/L
No   0 Yes  +1
Respiratory rate > 30
No   0 Yes  +1
Systolic BP < 90mmHg OR Diastolic BP < 60mmHg
No   0 Yes  +1
Age => 65
No   0 Yes  +1
Results 0.0
Treat as an outpatient
30-day death rate = 0.7%
Score Interpretation
0.0Treat as an outpatient

30-day death rate = 0.7%
1.0Treat as an outpatient

30-day death rate = 3.2%
2.0Consider a short stay in hospital

30-day death rate = 13.0%
3.0Consider a short stay in hospital

30-day death rate = 17.0%
4.0Requires hospitalization

30-day death rate = 41.5%
5.0Requires hospitalization

30-day death rate = 57.0%

Evidence

W Lim, M M van der Eerden, R Laing, W Boersma, N Karalus, G Town, S Lewis, and J Macfarlane. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003 May; 58(5): 377–382. doi: 10.1136/thorax.58.5.377.

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, Auble TE, Yealy DM, et al. Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia. Am. J. Med. 2005;118(4): 384–92.doi:10.1016/j.amjmed.2005.01.006. PMID 15808136

Myint PK, Kamath AV, Vowler SL, Maisey DN, Harrison BD. Severity assessment criteria recommended by the British Thoracic Society (BTS) for community-acquired pneumonia (CAP) and older patients. Should SOAR (systolic blood pressure, oxygenation, age and respiratory rate) criteria be used in older people? A compilation study of two prospective cohorts. Age Ageing. 2006;35(3):286-91.

Capelastegui A, España PP, Quintana JM, et al. Validation of a predictive rule for the management of community-acquired pneumonia. Eur Respir J. 2006;27(1):151-7.