CURB-65 Pneumonia Severity Score
Score five bedside criteria to stratify CAP severity and get a treatment setting recommendation — outpatient, inpatient, or ICU.
Use the CURB-65 Pneumonia Severity Score
Educational use only. This tool is not a substitute for clinical judgment. All pneumonia management decisions must be made by qualified clinicians based on full patient assessment including oxygenation, comorbidities, and social circumstances.
Five Bedside Criteria
Each criterion present adds 1 point. Maximum score: 5.
New acute confusion or disorientation — not pre-existing dementia or prior cognitive impairment.
Scores 1 point if urea > 7 mmol/L (BUN > 19.6 mg/dL). Enter value or select manually.
Entering a numeric value overrides the manual selection.
Scores 1 point if ≥ 30 breaths per minute.
Scores 1 point if systolic < 90 mmHg or diastolic ≤ 60 mmHg.
Scores 1 point if the patient is 65 years or older.
Enter the five criteria
and click Calculate.
CURB-65 Score & Setting
Criterion Breakdown
Suggested Next Steps
Score Interpretation & Treatment Setting Reference
| Score | Risk | 30-Day Mortality | Treatment Setting |
|---|---|---|---|
| 0 – 1 | Low | ~0.6–2.7% | Outpatient oral antibiotics with close follow-up |
| 2 | Moderate | ~9.2% | Short inpatient stay or closely supervised outpatient care |
| 3 | High | ~14.5% | Hospital admission required |
| 4 – 5 | Very High | ~40–57% | Hospital + consider ICU / high-dependency unit |
Summary
The CURB-65 score stratifies adults with community-acquired pneumonia into three treatment settings based on five bedside variables: Confusion (new acute disorientation), Urea above 7 mmol/L (BUN above 19.6 mg/dL), Respiratory rate at or above 30 breaths per minute, Blood pressure with systolic below 90 or diastolic at or below 60 mmHg, and Age 65 or older. A score of 0–1 supports outpatient oral antibiotics. A score of 2 warrants short inpatient admission or closely supervised outpatient care. Scores of 3–5 require hospital admission, with scores of 4–5 prompting consideration of ICU-level care. This tool accepts BUN in both mmol/L and mg/dL and shows a step-by-step treatment pathway for the calculated score.
How it works
- Select whether the patient has new acute confusion — not baseline dementia.
- Enter BUN in mmol/L or mg/dL; the calculator converts automatically and applies the 7 mmol/L threshold.
- Enter the respiratory rate; 30 or more breaths per minute scores 1 point.
- Enter systolic and diastolic blood pressure; hypotension (systolic < 90 or diastolic ≤ 60 mmHg) scores 1 point.
- Select whether the patient is aged 65 or older.
- Click Calculate to see the CURB-65 score, 30-day mortality estimate, and a treatment setting recommendation.
Use cases
- Decide between outpatient and inpatient treatment for adults with community-acquired pneumonia.
- Identify patients who may need ICU-level care based on a score of 4 or 5.
- Triage pneumonia patients in the emergency department using five rapid bedside assessments.
- Convert BUN values from mg/dL to mmol/L when applying the CURB-65 urea threshold.
- Communicate standardized severity to admitting teams during handover.
- Use as a teaching aid for medical students learning pneumonia management guidelines.
- Complement clinical judgment when determining the safest care setting for a patient.
- Track serial CURB-65 scores to monitor clinical progression or improvement.