CURB-65 Score
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The severity of community-acquired pneumonia can be assessed by using the CURB-65 score (1 point for each):
  • Confusion
  • Urea >7mmol/L
  • Respiratory rate ≥ 30/min
  • BP < 90 systolic and/or 60mmHg diastolic
  • Age ≥ 65


  • 0-1 home treatment possible
  • 2 hospital therapy
  • ≥ 3 indicates severe pneumonia

Treatments depend on the score, and there are usually local hospital guidelines to follow.

The score can also be used to predict 30-day mortality:

  • 0 – 0.6%
  • 1 – 3.2%
  • 2 – 13%
  • 3 – 17%
  • 4 – 41.5%
  • 5 – 57%


A modified version of the score, known as CRB-65 is often performed in general practice to assess the need for hospital admission. This omits ht urea measurement:

  • Confusion
  • Respiratory rate ≥ 30/min
  • BP < 90 systolic and/or 60mmHg diastolic
  • Age ≥ 65

In this modified version, a score of 1-2 indicated likely hospital admission, and 3+ indicated urgent hospital admission.

CRB-65 score and mortality
CRB-65 and mortality. Image from 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;58:377-382.

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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