CURB-65

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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]

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

Contents

[edit] 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]

[edit] 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

[edit] References

  1. ^ 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. ^ a b 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. 
  3. ^ 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. 
  4. ^ "BTS Guidelines for the Management of Community Acquired Pneumonia in Adults" (2001). Thorax 56 Suppl 4: IV1–64. PMID 11713364. 
  5. ^ 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. 

[edit] External links

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