CURB-65

From Ask Dr Wiki

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

1 Predicting death from pneumonia
2 Predicting death from any infection
3 References
4 External links

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]

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

References

↑ {{#if:Lim WS, van der Eerden MM, Laing R, et al |{{#if: |[[{{{authorlink}}}|{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Lim WS, van der Eerden MM, Laing R, et al }}]] |{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Lim WS, van der Eerden MM, Laing R, et al }} }} }}{{#if:Lim WS, van der Eerden MM, Laing R, et al |{{#if: | ; {{{coauthors}}} }} }}{{#if: | ({{{date}}}) |{{#if:2003 |{{#if: | ({{{month}}} 2003) | (2003) }} }} }}{{#if:Lim WS, van der Eerden MM, Laing R, et al | . }}{{#if:Lim WS, van der Eerden MM, Laing R, et al2003 | }}{{#ifeq: | no | | {{#if: |“|"}} }}{{#if: |[{{{url}}} Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study] |Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study }}{{#ifeq: | no | | {{#if:|”|"}} }}{{#if: | (in {{{language}}}) }}{{#if: | ({{{format}}}) }}{{#if:Thorax |. Thorax }}{{#if:58 | 58 }}{{#if:5 | (5) }}{{#if:377-82 |: 377-82 }}{{#if: |. {{#if: |{{{location}}}: }}{{{publisher}}} }}{{#if: |. doi:[1] }}{{#if: |. ISSN {{{issn}}} }}{{#if:12728155 |. PMID 12728155 }}{{#if: |. Bibcode: {{{bibcode}}} }}{{#if: |. OCLC {{{oclc}}} }}{{#if: |. {{{id}}} }}{{#if: |. Retrieved on [[{{{accessdate}}}]]{{#if: | , [[{{{accessyear}}}]] }} }}{{#if: | Retrieved on {{{accessmonthday}}}, {{{accessyear}}} }}{{#if: | Retrieved on {{{accessdaymonth}}} {{{accessyear}}} }}{{#if: |. [{{{laysummary}}} Lay summary]{{#if: | – {{{laysource}}}}} }}{{#if: | ([[{{{laydate}}}]]) }}.{{#if: | “{{{quote}}}” }}
↑ ^2.0 ^2.1 {{#if:Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI |{{#if: |[[{{{authorlink}}}|{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI }}]] |{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI }} }} }}{{#if:Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI |{{#if: | ; {{{coauthors}}} }} }}{{#if: | ({{{date}}}) |{{#if:2007 |{{#if: | ({{{month}}} 2007) | (2007) }} }} }}{{#if:Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI | . }}{{#if:Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI2007 | }}{{#ifeq: | no | | {{#if: |“|"}} }}{{#if: |[{{{url}}} Performance of severity of illness scoring systems in emergency department patients with infection] |Performance of severity of illness scoring systems in emergency department patients with infection }}{{#ifeq: | no | | {{#if:|”|"}} }}{{#if: | (in {{{language}}}) }}{{#if: | ({{{format}}}) }}{{#if:Academic emergency medicine : official journal of the Society for Academic Emergency Medicine |. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine }}{{#if:14 | 14 }}{{#if:8 | (8) }}{{#if:709-14 |: 709-14 }}{{#if: |. {{#if: |{{{location}}}: }}{{{publisher}}} }}{{#if:10.1197/j.aem.2007.02.036 |. doi:10.1197/j.aem.2007.02.036 }}{{#if: |. ISSN {{{issn}}} }}{{#if:17576773 |. PMID 17576773 }}{{#if: |. Bibcode: {{{bibcode}}} }}{{#if: |. OCLC {{{oclc}}} }}{{#if: |. {{{id}}} }}{{#if: |. Retrieved on [[{{{accessdate}}}]]{{#if: | , [[{{{accessyear}}}]] }} }}{{#if: | Retrieved on {{{accessmonthday}}}, {{{accessyear}}} }}{{#if: | Retrieved on {{{accessdaymonth}}} {{{accessyear}}} }}{{#if: |. [{{{laysummary}}} Lay summary]{{#if: | – {{{laysource}}}}} }}{{#if: | ([[{{{laydate}}}]]) }}.{{#if: | “{{{quote}}}” }}
↑ {{#if:Lim WS, Macfarlane JT, Boswell TC, et al |{{#if: |[[{{{authorlink}}}|{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Lim WS, Macfarlane JT, Boswell TC, et al }}]] |{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Lim WS, Macfarlane JT, Boswell TC, et al }} }} }}{{#if:Lim WS, Macfarlane JT, Boswell TC, et al |{{#if: | ; {{{coauthors}}} }} }}{{#if: | ({{{date}}}) |{{#if:2001 |{{#if: | ({{{month}}} 2001) | (2001) }} }} }}{{#if:Lim WS, Macfarlane JT, Boswell TC, et al | . }}{{#if:Lim WS, Macfarlane JT, Boswell TC, et al2001 | }}{{#ifeq: | no | | {{#if: |“|"}} }}{{#if: |[{{{url}}} Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines] |Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines }}{{#ifeq: | no | | {{#if:|”|"}} }}{{#if: | (in {{{language}}}) }}{{#if: | ({{{format}}}) }}{{#if:Thorax |. Thorax }}{{#if:56 | 56 }}{{#if:4 | (4) }}{{#if:296-301 |: 296-301 }}{{#if: |. {{#if: |{{{location}}}: }}{{{publisher}}} }}{{#if: |. doi:[2] }}{{#if: |. ISSN {{{issn}}} }}{{#if:11254821 |. PMID 11254821 }}{{#if: |. Bibcode: {{{bibcode}}} }}{{#if: |. OCLC {{{oclc}}} }}{{#if: |. {{{id}}} }}{{#if: |. Retrieved on [[{{{accessdate}}}]]{{#if: | , [[{{{accessyear}}}]] }} }}{{#if: | Retrieved on {{{accessmonthday}}}, {{{accessyear}}} }}{{#if: | Retrieved on {{{accessdaymonth}}} {{{accessyear}}} }}{{#if: |. [{{{laysummary}}} Lay summary]{{#if: | – {{{laysource}}}}} }}{{#if: | ([[{{{laydate}}}]]) }}.{{#if: | “{{{quote}}}” }}
↑ {{#if: |{{#if: |[[{{{authorlink}}}|{{#if: |{{{last}}}{{#if: |, {{{first}}} }} | }}]] |{{#if: |{{{last}}}{{#if: |, {{{first}}} }} | }} }} }}{{#if: |{{#if: | ; {{{coauthors}}} }} }}{{#if: | ({{{date}}}) |{{#if:2001 |{{#if: | ({{{month}}} 2001) | (2001) }} }} }}{{#if: | . }}{{#if:2001 | }}{{#ifeq: | no | | {{#if: |“|"}} }}{{#if: |[{{{url}}} BTS Guidelines for the Management of Community Acquired Pneumonia in Adults] |BTS Guidelines for the Management of Community Acquired Pneumonia in Adults }}{{#ifeq: | no | | {{#if:|”|"}} }}{{#if: | (in {{{language}}}) }}{{#if: | ({{{format}}}) }}{{#if:Thorax |. Thorax }}{{#if:56 Suppl 4 | 56 Suppl 4 }}{{#if: | () }}{{#if:IV1-64 |: IV1-64 }}{{#if: |. {{#if: |{{{location}}}: }}{{{publisher}}} }}{{#if: |. doi:[3] }}{{#if: |. ISSN {{{issn}}} }}{{#if:11713364 |. PMID 11713364 }}{{#if: |. Bibcode: {{{bibcode}}} }}{{#if: |. OCLC {{{oclc}}} }}{{#if: |. {{{id}}} }}{{#if: |. Retrieved on [[{{{accessdate}}}]]{{#if: | , [[{{{accessyear}}}]] }} }}{{#if: | Retrieved on {{{accessmonthday}}}, {{{accessyear}}} }}{{#if: | Retrieved on {{{accessdaymonth}}} {{{accessyear}}} }}{{#if: |. [{{{laysummary}}} Lay summary]{{#if: | – {{{laysource}}}}} }}{{#if: | ([[{{{laydate}}}]]) }}.{{#if: | “{{{quote}}}” }}
↑ {{#if:Aujesky D, Auble TE, Yealy DM, et al |{{#if: |[[{{{authorlink}}}|{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Aujesky D, Auble TE, Yealy DM, et al }}]] |{{#if: |{{{last}}}{{#if: |, {{{first}}} }} |Aujesky D, Auble TE, Yealy DM, et al }} }} }}{{#if:Aujesky D, Auble TE, Yealy DM, et al |{{#if: | ; {{{coauthors}}} }} }}{{#if: | ({{{date}}}) |{{#if:2005 |{{#if: | ({{{month}}} 2005) | (2005) }} }} }}{{#if:Aujesky D, Auble TE, Yealy DM, et al | . }}{{#if:Aujesky D, Auble TE, Yealy DM, et al2005 | }}{{#ifeq: | no | | {{#if: |“|"}} }}{{#if: |[{{{url}}} Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia] |Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia }}{{#ifeq: | no | | {{#if:|”|"}} }}{{#if: | (in {{{language}}}) }}{{#if: | ({{{format}}}) }}{{#if:Am. J. Med. |. Am. J. Med. }}{{#if:118 | 118 }}{{#if:4 | (4) }}{{#if:384-92 |: 384-92 }}{{#if: |. {{#if: |{{{location}}}: }}{{{publisher}}} }}{{#if:10.1016/j.amjmed.2005.01.006 |. doi:10.1016/j.amjmed.2005.01.006 }}{{#if: |. ISSN {{{issn}}} }}{{#if:15808136 |. PMID 15808136 }}{{#if: |. Bibcode: {{{bibcode}}} }}{{#if: |. OCLC {{{oclc}}} }}{{#if: |. {{{id}}} }}{{#if: |. Retrieved on [[{{{accessdate}}}]]{{#if: | , [[{{{accessyear}}}]] }} }}{{#if: | Retrieved on {{{accessmonthday}}}, {{{accessyear}}} }}{{#if: | Retrieved on {{{accessdaymonth}}} {{{accessyear}}} }}{{#if: |. [{{{laysummary}}} Lay summary]{{#if: | – {{{laysource}}}}} }}{{#if: | ([[{{{laydate}}}]]) }}.{{#if: | “{{{quote}}}” }}