CURB-65
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; ; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]
Overview
CURB-65 is a clinical prediction rule that has been validated for predicting mortality in community-acquired pneumonia[1] and infection of any site[2]. The CURB-65 is based on the earlier CURB score[3] and is recommended by the British Thoracic Society for the assessment of severity of pneumonia.[4]
CURB 65
The score is an acronym for each of the risk factors measured. Each risk factor scores one point, for a maximum score of 5:
- confusion (defined as an AMT of 8 or less)
- urea greater than 7 mmol/l (Blood Urea Nitrogen > 20)
- respiratory rate of 30 breaths per minute or greater
- blood pressure less than 90 systolic or diastolic blood pressure 60 or less
- age 65 or older
Predicting Death from Pneumonia
The risk of death increases as the score increases:
- 0—0.7%
- 1—3.2%
- 2—13.0%
- 3—17.0%
- 4—41.5%
- 5—57.0%
The CURB-65 has been compared to the pneumonia severity index in predicting mortality from pneumonia.[5]
Predicting Death from Any Infection
A cohort study of patients with any type of infection (half of the patients had pneumonia), the risk of death increases as the score increases[2]:
- 0 to 1 <5% mortality
- 2 to 3 < 10% mortality
- 4 to 5 15-30% mortality
References
- ↑ Lim WS, van der Eerden MM, Laing R; et al. (2003). "Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study". Thorax. 58 (5): 377–82. PMID 12728155.
- ↑ 2.0 2.1 Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI (2007). "Performance of severity of illness scoring systems in emergency department patients with infection". Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 14 (8): 709–14. doi:10.1197/j.aem.2007.02.036. PMID 17576773.
- ↑ Lim WS, Macfarlane JT, Boswell TC; et al. (2001). "Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines". Thorax. 56 (4): 296–301. PMID 11254821.
- ↑ "BTS Guidelines for the Management of Community Acquired Pneumonia in Adults". Thorax. 56 Suppl 4: IV1–64. 2001. PMID 11713364.
- ↑ Aujesky D, Auble TE, Yealy DM; et al. (2005). "Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia". Am. J. Med. 118 (4): 384–92. doi:10.1016/j.amjmed.2005.01.006. PMID 15808136.
External Links
- British Thoracic Society
- ICU Medicus Pneumonia Severity Score - online calculator for the CURB-65