The CURB-65 Calculator scores community-acquired pneumonia (CAP) severity using five clinical criteria. Answer yes or no to Confusion, Urea > 7 mmol/L, Respiratory Rate ≥ 30/min, Low Blood Pressure, and Age ≥ 65 — and get back a CURB-65 score, estimated 30-day mortality risk, and a recommended care setting (home, hospital, or ICU consideration).
CURB-65 Score
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Estimated 30-Day Mortality
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Severity Classification
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Recommended Management
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Community-acquired pneumonia is a lung infection contracted outside of a hospital or healthcare facility. It is caused by bacteria, viruses, or fungi and is one of the most common serious infectious diseases worldwide. Symptoms include cough, fever, chest pain, and difficulty breathing.
CURB-65 is an acronym for the five criteria scored: Confusion (new acute disorientation), Urea > 7 mmol/L, Respiratory rate ≥ 30/min, Blood pressure low (systolic < 90 mmHg or diastolic ≤ 60 mmHg), and age 65 or older. Each criterion scores 1 point, giving a maximum score of 5.
A score of 0–1 indicates low mortality risk (~1.5%) and patients are likely suitable for outpatient home treatment. A score of 2 suggests intermediate risk (~9.2%) and hospital-supervised treatment should be considered. A score of 3 or above signals high mortality risk (~22%) and warrants inpatient management as severe pneumonia; scores of 4 or 5 should prompt assessment for ICU admission.
The CURB-65 score was developed by Lim et al. and published in Thorax in 2003. It was derived and validated using data from 1,068 patients across three prospective studies conducted in the UK, New Zealand, and the Netherlands.
The Pneumonia Severity Index (PORT score) is an older, more detailed scoring system that has shown slightly better predictive performance than CURB-65. However, the relative simplicity of CURB-65 — requiring only five easily obtained clinical criteria — makes it more practical and appealing for everyday clinical use.
The CURB-65 score has not been formally validated for use in COVID-19 pneumonia. While its criteria are clinically relevant, COVID-19 can present atypically, and other scoring tools specifically developed or adapted for COVID-19 may be more appropriate in that context.
A high CURB-65 score is a clinical decision-support tool — it should guide but not replace a physician's full assessment. If the score suggests hospital or ICU-level care, the clinician will consider additional factors including oxygen saturation, comorbidities, and chest imaging before making a final disposition decision.
No. CURB-65 was specifically designed and validated for community-acquired pneumonia (CAP). Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) involve different pathogens and patient profiles, and require separate risk stratification tools.