CURB-65
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CURB-65, also known as the CURB criteria, is a
clinical prediction rule A clinical prediction rule or clinical probability assessment specifies how to use medical signs, symptoms, and other findings to estimate the probability of a specific disease or clinical outcome. Physicians have difficulty in estimated risks of ...
that has been validated for predicting mortality in
community-acquired pneumonia Community-acquired pneumonia (CAP) refers to pneumonia (any of several lung diseases) contracted by a person outside of the healthcare system. In contrast, hospital-acquired pneumonia (HAP) is seen in patients who have recently visited a hospital ...
and infection of any site. The CURB-65 is based on the earlier CURB score and is recommended by the
British Thoracic Society The British Thoracic Society (BTS) was formed in 1982 by the amalgamation of the British Thoracic Association and the Thoracic Society. It is a registered charity and a company limited by guarantee. Function The society's main charitable objecti ...
for the assessment of severity of pneumonia. It was developed in 2002 at the
University of Nottingham , mottoeng = A city is built on wisdom , established = 1798 – teacher training college1881 – University College Nottingham1948 – university status , type = Public , chancellor ...
by Dr. W.S. Lim et al. In 2018 a new toolkit was presented on the basis of CURB-65. The score is an
acronym An acronym is a word or name formed from the initial components of a longer name or phrase. Acronyms are usually formed from the initial letters of words, as in ''NATO'' (''North Atlantic Treaty Organization''), but sometimes use syllables, as ...
for each of the risk factors measured. Each risk factor scores one point, for a maximum score of 5: * Confusion of new onset (defined as an AMTS of 8 or less) * Blood Urea nitrogen greater than 7 mmol/L (19 mg/dL) * Respiratory rate of 30 breaths per minute or greater * Blood pressure less than 90 mmHg systolic or diastolic blood pressure 60 mmHg or less * Age 65 or older


Predicting death


Pneumonia

The risk of death at 30 days 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. It was shown that the PSI has a higher discriminatory power for short-term mortality, and thus is more accurate for low risk patients than the CURB-65 or its predecessor, the CURB score. However, the PSI is more complicated and requires arterial blood gas sampling amongst other tests; given this, the CURB-65 score is more easily used in primary care settings. A variant of the CURB-65 that omits the urea measurement (CRB-65) is even simpler, as it relies only on history and examination findings rather than blood tests. The CURB-65 is used as a means of deciding the action that is needed to be taken for that patient. * 0-1: Treat as an outpatient * 2: Consider a short stay in hospital or watch very closely as an outpatient * 3-5: Requires hospitalization with consideration as to whether they need to be in the intensive care unit


Any infection

Patients with any type of infection (half of the patients had pneumonia), the risk of death increases as the score increases: * 0 to 1: <5% mortality * 2 to 3: < 10% mortality * 4 to 5: 15-30% mortality


References

{{Respiratory system procedures Diagnostic intensive care medicine Diagnostic pulmonology Medical scales Science and technology in Nottinghamshire University of Nottingham