View source for CURB-65

{{Pneumonia}}
{{CMG}}; ; Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com]
==Overview==
'''CURB-65''' is a [[clinical prediction rule]] that has been validated for predicting mortality in [[community-acquired pneumonia]]<ref name="pmid12728155">{{cite journal |author=Lim WS, van der Eerden MM, Laing R, ''et al'' |title=Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study |journal=Thorax |volume=58 |issue=5 |pages=377-82 |year=2003 |pmid=12728155 |doi=}}</ref> and infection of any site<ref name="pmid17576773">{{cite journal |author=Howell MD, Donnino MW, Talmor D, Clardy P, Ngo L, Shapiro NI |title=Performance of severity of illness scoring systems in emergency department patients with infection |journal=Academic emergency medicine : official journal of the Society for Academic Emergency Medicine |volume=14 |issue=8 |pages=709-14 |year=2007 |pmid=17576773 |doi=10.1197/j.aem.2007.02.036}}</ref>. The CURB-65 is based on the earlier CURB score<ref name="pmid11254821">{{cite journal |author=Lim WS, Macfarlane JT, Boswell TC, ''et al'' |title=Study of community acquired pneumonia aetiology (SCAPA) in adults admitted to hospital: implications for management guidelines |journal=Thorax |volume=56 |issue=4 |pages=296-301 |year=2001 |pmid=11254821 |doi=}}</ref> and is recommended by the [[British Thoracic Society]] for the assessment of severity of pneumonia.<ref name="pmid11713364">{{cite journal |author= |title=BTS Guidelines for the Management of Community Acquired Pneumonia in Adults |journal=Thorax |volume=56 Suppl 4 |issue= |pages=IV1-64 |year=2001 |pmid=11713364 |doi=}}</ref>
==CURB 65==
The score is an acronym for each of the risk factors measured.  Each risk factor scores one point, for a maximum score of 5:
* '''C'''onfusion (defined as an [[abbreviated mental test score|AMT]] of 8 or less)
* '''U'''rea greater than 7 mmol/l (Blood Urea Nitrogen > 20)
* '''R'''espiratory rate of 30 breaths per minute or greater
* '''B'''lood pressure less than 90 systolic or diastolic blood pressure 60 or less
* Age '''65''' or older

==Predicting Death from Pneumonia==
The risk of death increases as the score increases.
{| style="border: 0px; font-size: 85%; margin: 3px; width:200px;" align=center
|valign=top|
|+
! style="background: #4479BA; color:#FFF;  width: 200px;" | CURB-65 Score  
! style="background: #4479BA; color:#FFF;  width: 200px;" | Risk of death
|-
| style="padding: 5px 5px; background: #DCDCDC;text-align:center;font-weight: bold" |  0
| style="padding: 5px 5px; background: #F5F5F5;text-align:center;" |0.7%
|-
| style="padding: 5px 5px; background: #DCDCDC;text-align:center;font-weight: bold" | 1 
| style="padding: 5px 5px; background: #F5F5F5;text-align:center;" |3.2%

|-
| style="padding: 5px 5px; background: #DCDCDC;text-align:center;font-weight: bold" |  2
| style="padding: 5px 5px; background: #F5F5F5;text-align:center;" |13.0%

|-
| style="padding: 5px 5px; background: #DCDCDC;text-align:center;font-weight: bold" |  3
| style="padding: 5px 5px; background: #F5F5F5;text-align:center;" |17.0%

|-
| style="padding: 5px 5px; background: #DCDCDC;text-align:center;font-weight: bold" |  4
| style="padding: 5px 5px; background: #F5F5F5;text-align:center;" |41.5%

|-
| style="padding: 5px 5px; background: #DCDCDC;text-align:center;font-weight: bold" |  5
| style="padding: 5px 5px; background: #F5F5F5;text-align:center;" |57.0%
|}

The CURB-65 has been compared to the [[pneumonia severity index]] in predicting mortality from pneumonia.<ref name="pmid15808136">{{cite journal |author=Aujesky D, Auble TE, Yealy DM, ''et al'' |title=Prospective comparison of three validated prediction rules for prognosis in community-acquired pneumonia |journal=Am. J. Med. |volume=118 |issue=4 |pages=384-92 |year=2005 |pmid=15808136 |doi=10.1016/j.amjmed.2005.01.006}}</ref>

==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<ref name="pmid17576773"/>:
* 0 to 1 <5% mortality
* 2 to 3 < 10% mortality
* 4 to 5 15-30% mortality

==References==
{{Reflist|2}}

==External Links==
*[http://www.brit-thoracic.org.uk British Thoracic Society]
*[http://www.icumedicus.com/clinical_criteria/pneumonia_severity_score.php ICU Medicus Pneumonia Severity Score] - online calculator for the CURB-65



[[Category:Pulmonology]]
[[Category:Medical signs]]
[[Category:Drugs]]

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