Pulmonology Book


Mortality Prediction Tool for Patients with Community Acquired Pneumonia

Aka: Mortality Prediction Tool for Patients with Community Acquired Pneumonia, CURB-65
  1. See Also
    1. Community Acquired Pneumonia
    2. SOAR Pneumonia Score
  2. Indications
    1. Community Acquired Pneumonia Assessment for Disposition (Outpatient, Inpatient or ICU admission)
  3. Criteria: Assign one point for each of positive criteria
    1. Confusion
    2. Blood Urea Nitrogen (BUN) >20 mg/dl
    3. Respiratory Rate 30 breaths/min or higher
    4. Systolic Blood Pressure <90 mmHg or Diastolic Blood Pressure <60 mmHg
    5. Age 65 years or older
  4. Interpretation
    1. Score 0-1: Outpatient management (30 day mortality <2.1%)
    2. Score 2: Inpatient management (30 day mortality 9.2%)
    3. Score 3: Intensive Care management (30 day mortality 15-40%)
  5. Efficacy
    1. Poor Test Sensitivity (use other prediction tools for low scores)
    2. High Test Specificity (strongly consider ICU admission for higher scores)
  6. Disadvantages
    1. When used as a triage tool (for hospitalization), misses borderline cases (low Test Sensitivity)
    2. Does not include Hypoxia in its criteria
    3. Requires Blood Urea Nitrogen (remainder of criteria may be identified bedside)
  7. References
    1. Lim (2009) Thorax 64(suppl 3):1-55 [PubMed]

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