CURB-65 Calculator
Calculate the CURB-65 score to assess pneumonia severity and predict 30-day mortality risk in community-acquired pneumonia patients
CURB-65 Criteria
New onset confusion or disorientation in person, place, or time
Blood urea nitrogen level indicating renal impairment
Elevated respiratory rate indicating respiratory distress
Hypotension indicating hemodynamic compromise
Advanced age as a risk factor for poor outcomes
What is the CURB-65 Calculator?
The CURB-65 Calculator is a widely-used clinical prediction tool designed to assess the severity of community-acquired pneumonia (CAP) and predict 30-day mortality risk. Developed by the British Thoracic Society, the CURB-65 Calculator provides a simple yet effective method for healthcare providers to make evidence-based decisions about patient care and treatment settings.
This CURB-65 Calculator evaluates five key clinical criteria: Confusion, Urea levels, Respiratory rate, Blood pressure, and age 65 or older. Each criterion contributes one point to the total score, creating a maximum possible score of 5 points. The CURB-65 Calculator stratifies patients into low, intermediate, and high-risk categories, enabling clinicians to determine appropriate treatment locations and intensity of care.
Healthcare professionals worldwide rely on the CURB-65 Calculator for its simplicity and clinical utility in emergency departments, primary care settings, and hospital wards. The CURB-65 Calculator has been extensively validated across diverse patient populations and healthcare systems, making it an essential tool for pneumonia management and quality improvement initiatives.
How to Use the CURB-65 Calculator
Assess Mental Status (C)
Evaluate the patient for confusion or altered mental status using the CURB-65 Calculator. Check for new onset disorientation in person, place, or time.
Check Urea Levels (U)
Enter the blood urea nitrogen (BUN) value into the CURB-65 Calculator. A level greater than 19 mg/dL (7 mmol/L) indicates renal impairment.
Measure Respiratory Rate (R)
Record the patient's respiratory rate in the CURB-65 Calculator. A rate of 30 breaths per minute or higher indicates respiratory distress.
Record Blood Pressure (B)
Input systolic and diastolic blood pressure values into the CURB-65 Calculator. Hypotension (systolic <90 or diastolic ≤60 mmHg) scores one point.
Document Age (65)
Enter the patient's age in the CURB-65 Calculator. Patients aged 65 years or older receive one point for increased mortality risk.
Calculate and Interpret
Click calculate to generate the CURB-65 score, risk stratification, mortality prediction, and treatment recommendations.
CURB-65 Calculator Formula and Scoring
CURB-65 Criteria (1 point each)
C - Confusion
New onset confusion or altered mental status
Disorientation in person, place, or time
U - Urea
BUN > 19 mg/dL (7 mmol/L)
Indicates renal impairment
R - Respiratory Rate
≥ 30 breaths per minute
Indicates respiratory distress
B - Blood Pressure
Systolic < 90 mmHg OR Diastolic ≤ 60 mmHg
Indicates hemodynamic compromise
65 - Age
≥ 65 years old
Advanced age as risk factor
Total Score
0-5 points
Sum of all positive criteria
Real-Life CURB-65 Calculator Example
Case Presentation
Patient: 78-year-old female
Presentation: Community-acquired pneumonia
Mental Status: Alert and oriented
Laboratory: BUN 25 mg/dL
Vital Signs:
- • Respiratory rate: 32/min
- • Blood pressure: 85/55 mmHg
- • Heart rate: 115 bpm
- • Temperature: 38.9°C
CURB-65 Calculation
CURB-65 Criteria Assessment:
- • Confusion: No (0 points)
- • Urea: 25 mg/dL > 19 (1 point)
- • Respiratory rate: 32 ≥ 30 (1 point)
- • Blood pressure: 85/55 < 90/60 (1 point)
- • 65: Age 78 ≥ 65 (1 point)
Total CURB-65 Score: 4/5
Risk Level: High Risk
30-day Mortality: 40%
Recommendation: Urgent hospitalization
Key Use Cases for CURB-65 Calculator
Emergency Medicine
Emergency physicians use the CURB-65 Calculator for rapid pneumonia severity assessment and disposition decisions in busy ED environments.
Primary Care
Family physicians and internists utilize the CURB-65 Calculator to identify patients suitable for outpatient management versus hospital referral.
Urgent Care
Urgent care providers employ the CURB-65 Calculator to make evidence-based decisions about pneumonia treatment and referral patterns.
Hospital Medicine
Hospitalists reference CURB-65 Calculator scores for admission decisions, monitoring requirements, and discharge planning protocols.
Telemedicine
Remote healthcare providers use the CURB-65 Calculator to assess pneumonia severity during virtual consultations and triage decisions.
Quality Metrics
Healthcare systems incorporate CURB-65 Calculator data into pneumonia care pathways and performance improvement initiatives.
Expert Tips for CURB-65 Calculator
Bedside Simplicity
The CURB-65 Calculator's five-criteria design allows for mental calculation without complex scoring systems, making it ideal for bedside use and rapid assessment.
Social Factors
Consider social determinants of health when interpreting CURB-65 Calculator results, as home support systems may influence appropriate treatment settings.
Timing Considerations
Assess CURB-65 Calculator criteria at presentation before interventions like fluid resuscitation or oxygen therapy that may alter baseline values.
Clinical Judgment
Use CURB-65 Calculator results as guidance rather than absolute rules, always incorporating clinical judgment and patient-specific factors in decision-making.
Documentation Standards
Document all CURB-65 Calculator components clearly in medical records to support clinical decisions and facilitate care transitions.
Patient Communication
Explain CURB-65 Calculator results to patients and families in understandable terms to support shared decision-making and treatment adherence.
Frequently Asked Questions
What does CURB-65 stand for?
CURB-65 represents the five criteria: Confusion, Urea (BUN >19 mg/dL), Respiratory rate (≥30/min), Blood pressure (<90/60 mmHg), and age 65 or older. Each criterion contributes one point to the total score.
Can CURB-65 Calculator be used for all pneumonia types?
The CURB-65 Calculator was developed specifically for community-acquired pneumonia. It should not be used for hospital-acquired, ventilator-associated, or healthcare-associated pneumonia cases.
How does CURB-65 compare to other pneumonia severity scores?
CURB-65 Calculator is simpler than PSI/PORT with fewer variables, making it more practical for bedside use. However, PSI/PORT provides more detailed risk stratification with 20 variables.
What if BUN is not available for CURB-65 calculation?
Without BUN, you can use CRB-65 (excluding urea), though this may slightly reduce predictive accuracy. The CURB-65 Calculator works best with complete data.
Should CURB-65 Calculator guide antibiotic selection?
CURB-65 Calculator primarily guides treatment setting decisions rather than antibiotic choice. Use local guidelines and antibiograms for antimicrobial selection based on severity and risk factors.
How often should CURB-65 be reassessed?
CURB-65 Calculator is typically used at initial presentation. Reassessment may be helpful if clinical status changes significantly or for discharge planning decisions.
CURB-65 Calculator: Facts and Figures
Simple criteria for rapid assessment
C-statistic for mortality prediction
Year of original development
Sensitivity for identifying high-risk patients
Clinical Validation
- • Validated across multiple healthcare systems globally
- • Endorsed by British Thoracic Society guidelines
- • Incorporated into international pneumonia protocols
- • Demonstrated cost-effectiveness in multiple studies
Implementation Impact
- • Reduces inappropriate hospitalizations by 25-40%
- • Improves resource allocation efficiency
- • Supports standardized pneumonia care pathways
- • Facilitates quality improvement initiatives
CURB-65 Calculator vs PSI/PORT Score
| Feature | CURB-65 Calculator | PSI/PORT Score |
|---|---|---|
| Number of Variables | 5 clinical criteria | 20 clinical variables |
| Ease of Use | Simple, can calculate mentally | Complex, requires calculator |
| Risk Stratification | 3 risk levels (Low, Intermediate, High) | 5 risk classes (I-V) |
| Laboratory Requirements | BUN only | Multiple laboratory values |
| Time to Calculate | < 1 minute | 2-5 minutes |
| Best Setting | Emergency department, primary care | Hospital wards, detailed assessment |