CURB-65 Score

The CURB-65 is a simple scoring system easily used in the outpatient office or emergency room setting, which assigns 1 point for each of 5 clinical features:

Clinical Factor Points
    C Confusion 1
    U Blood urea nitrogen > or = 20 mg/dL 1
    R Respiratory rate > or = 30 breaths/min 1
    B Systolic BP < 90 mm Hg or Diastolic BP < or = 60 mm Hg 1
    65 Age > or = 65 1

A single point is given for the presence of delirium or confusion, a blood urea nitrogen value greater than or equal to 20, a respiratory rate greater than or equal to 30, a systolic blood pressure less than 90 mm Hg or a diastolic blood pressure less than or equal to 60, and an age greater than or equal to 65 years of age.

If the cumulative score is 0 or 1, then most likely this patient could be safely treated as an outpatient.

A score of 2 might suggest closely supervised outpatient treatment, or inpatient observation admission. A score of 3, 4, or 5 would usually indicate inpatient treatment.

It is important to emphasize that clinical judgment should be the primary factor in the decision for hospital admission, with the CURB-65 score providing assistance with this decision.

    Total Score Mortality % Risk Level Suggested Site-of-Care 0 0.6% Low Outpatient
    1 2.7% Low Outpatient
    2 6.8% Moderate Short inpatient / supervised outpatient
    3 14.0% Moderate to High Inpatient
    4 or 5 27.8% High Inpatient / ICU