CURB-65 (Pneumonia Severity)

One point for each criterion present on presentation.

ConfusionNew onset — AMT ≤ 8, or new disorientation in person, place or timeUrea > 7 mmol/LRoughly BUN > 19 mg/dLRespiratory rate ≥ 30 breaths/minBlood pressureSystolic < 90 mmHg, or diastolic ≤ 60 mmHgAge ≥ 65 years

0 / 5

Low severity — generally suitable for treatment at home.

The 0–1 / 2 / 3–5 banding is the conventional management grouping that accompanies the score rather than part of the score itself, and mortality rises steeply across it.

It is a severity score, not a disposition rule.It doesn't account for hypoxia, comorbidity, social circumstances, or the ability to take oral antibiotics — a low score in a hypoxic or unsupported patient still warrants admission.

Urea is the criterion most often missed at triage, since it needs bloods back — the score can only be completed once they are.

Source: Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003;58(5):377–382.