Curb-65

CURB-65 is the acronym for a simple (and well evaluated-Ilg A et al. 2019) clinical evaluation system for patients with pneumonia.

The individual letters stand for:

• C = Confusion: Pneumonia-related confusion (disorientation to place, time or person)
• U = Urea (serum urea): > 7 mmol/L
• R = Respiratory rate: > 30/min
• B = Blood pressure: Systolic below 90 mmHg or diastolic below 60 mmHg
• 65 = Patient is ≥ 65 years old

The score is used to quickly assess the severity of the disease and the associated intensity of the therapy measure. A maximum of 5 points are awarded, which are associated with different lethality (values in brackets - Ilg A et al. 2019) and thus give an indication of whether patients can be treated as outpatients or should be treated as inpatients or even in intensive care.

• Score 0: (1-2%)
• Score 1-2: (13%)
• Score 3-4(5): (>31%)

Similar scores for risk stratification of community acquired pneumonia (CAP) are the CURB index (without taking age into account) and the CRB-65 index (without taking urea (U) in serum into account).

1. Ilg A et al (2019) Performance of the CURB-65 Score in Predicting Critical Care Interventions in Patients Admitted With Community-Acquired Pneumonia. Ann Emerg Med 74:60-68.
2. Murillo-Zamora E et al (2018) Performance of the PSI and CURB-65 scoring systems in predicting 30-day mortality in healthcare-associated pneumonia. Med Clin (Barc) 150:99-103.
3. Pflug MA et al.(2015) Short-term mortality of adult inpatients with community-acquired pneumonia: external validation of a modified CURB-65 score. Postgraduate Med J 91:77-82.