Crb-65

CRB-65 is the acronym for a clinical score that can be used to quickly assess the severity of outpatient acquired pneumonia.

The individual letters stand for:

• C = Confusion: Pneumonia-related confusion (disorientation to place, time or person)
• R = Respiratory rate: > 30/min
• B = Blood pressure: > 90/60mmHG

The value defines a statistical probability of death from pneumonia.

One point is indexed for each criterion determined, the maximum number of points is 4.

Patients with a CRB score of 0 (no significantly increased mortality rate) can be treated as outpatients. For outpatient treatment, a "second look" should be arranged after 24-48 hours.

For patients with a CRB score of 1-2 (mortality rate 5%), inpatient admission is recommended.

Intensive therapy is necessary for patients with a CRB score of 3-4 (mortality rate > 20%).

A variant of the CRB-65 is the CURB. In this acronym the "U" stands for urea (urea-nitrogen) > 7 mmol/l. This score, however, requires a timely laboratory diagnosis.

1. Bauer TT et al. CRB-65 predicts death from community-acquired pneumonia. J Internal Med. 2006 260:93-101
2. Dwyer R et al (2014) Improvement of CRB-65 as a prognostic tool in adult patients with community-acquired pneumonia. BMJ Open Respir Res 8: e000038.
3. Ebell MH et al (2019) Meta-analysis of Calibration, Discrimination, and Stratum-Specific Likelihood Ratios for the CRB-65 Score. J Gene Internal Med 34:1304-1313.
4. Frenzen FS et al. (2018) Admission lactate predicts poor prognosis independently of the CRB/CURB-65 scores in community-acquired pneumonia. Clin Microbiol Infect 24: 306.e1-306.e6.