# CURB-65 vs PSI vs SMART-COP (Pneumonia Severity Comparison)

Compare three pneumonia severity scores side-by-side from one set of inputs to support concordance reading. CURB-65 (0-5: Confusion, Urea, RR, BP, age ≥65) — quick bedside triage; PSI/PORT (Fine 1997, 5 risk classes) — the most accurate mortality stratification, more complex; SMART-COP (0-10, 2 points each for SBP <90 and hypoxia, 1 point each for multilobar CXR, albumin <3.5, RR ≥25, tachycardia ≥125, confusion, pH <7.35) — predicts need for ICU respiratory/vasopressor support. Each score has a different focus: CURB-65 is fast; PSI is more precise; SMART-COP identifies who needs ICU. The tool reports each score's total/category/interpretation and an agreement analysis (whether all three point to outpatient/admission/ICU). When scores disagree, favor the more conservative disposition. Derived from Lim 2003, Fine 1997, Charles 2008. Not medical advice.

> Canonical page: https://elysiatools.com/en/tools/curb-65-vs-pneumonia-severity

- **Category:** Health

- **Keywords:** CURB-65, PSI, PORT, SMART-COP, pneumonia, CAP, severity, comparison, ICU, triage, concordance

## Overview

Compare CURB-65, PSI/PORT, and SMART-COP pneumonia severity scores from one set of clinical inputs. The tool returns each total, category, interpretation, and an agreement analysis for outpatient care, hospital admission, or ICU-level concern. It is for clinical reference and is not medical advice.

## Inputs

- **Age** (number): Age in years. Used by all three scores.
- **Sex** (select): PSI subtracts 10 points for women.
- **Nursing home resident** (checkbox): PSI +10.
- **Confusion (new onset)** (checkbox): CURB-65 +1; SMART-COP +1.
- **Urea > 7 mmol/L (BUN > 20 mg/dL)** (checkbox): CURB-65 +1; PSI +20 (BUN ≥30 mg/dL family).
- **Respiratory rate ≥ 30/min** (checkbox): CURB-65 +1; PSI +20.
- **Respiratory rate ≥ 25/min (SMART-COP)** (checkbox): SMART-COP +1 (lower RR threshold than CURB-65).
- **Systolic BP < 90 mmHg** (checkbox): CURB-65 +1; PSI +20; SMART-COP +2.
- **Diastolic BP ≤ 60 mmHg** (checkbox): CURB-65 +1 (CURB-65 BP criterion, OR with SBP).
- **Pulse ≥ 125/min** (checkbox): PSI +10; SMART-COP +1.
- **Temperature < 35°C or ≥ 40°C** (checkbox): PSI +15 (and PSI Step 1 screening).
- **Arterial pH < 7.35** (checkbox): PSI +30; SMART-COP +1.
- **Sodium < 130 mmol/L** (checkbox): PSI +20.
- **Glucose ≥ 250 mg/dL** (checkbox): PSI +10.
- **Hematocrit < 30%** (checkbox): PSI +10.
- **PaO₂ < 60 mmHg or O₂ sat < 90%** (checkbox): PSI +10; SMART-COP +2 (hypoxia).
- **Pleural effusion on chest X-ray** (checkbox): PSI +10.
- **Multilobar infiltrate on chest X-ray** (checkbox): SMART-COP +1.
- **Albumin < 3.5 g/dL** (checkbox): SMART-COP +1.
- **Neoplastic disease** (checkbox): PSI +30 (and PSI Step 1 screening).
- **Liver disease** (checkbox): PSI +20 (and PSI Step 1 screening).
- **Congestive heart failure** (checkbox): PSI +10 (and PSI Step 1 screening).
- **Cerebrovascular disease** (checkbox): PSI +10 (and PSI Step 1 screening).
- **Renal disease** (checkbox): PSI +10 (and PSI Step 1 screening).

## When to use

- When assessing community-acquired pneumonia severity with several validated scoring systems.
- When you need to compare rapid CURB-65 triage with the more detailed PSI and ICU-focused SMART-COP score.
- When the scores may disagree and you want a side-by-side view to support a more conservative disposition decision.

## How it works

- Enter the patient's age and sex, then select applicable clinical findings, vital-sign thresholds, laboratory results, imaging findings, and comorbidities.
- The tool calculates CURB-65, PSI/PORT, and SMART-COP from the same inputs.
- Each result includes a total score, risk category, and interpretation.
- The tool compares the three outputs and reports whether they are concordant for outpatient care, admission, or ICU-level concern.

## Use cases

- Emergency and acute-care triage for adults with suspected community-acquired pneumonia.
- Clinical education comparing the inputs and focus of CURB-65, PSI, and SMART-COP.
- Structured review of discordant pneumonia severity assessments before disposition planning.

## Frequently asked questions

### What scores does this tool compare?

It compares CURB-65, PSI/PORT, and SMART-COP for pneumonia severity.

### What information is required?

Age and sex are required. Other inputs cover symptoms, vital signs, laboratory findings, chest X-ray findings, and selected comorbidities.

### What does CURB-65 measure?

CURB-65 uses confusion, urea, respiratory rate, blood pressure, and age 65 or older for rapid bedside triage.

### What is SMART-COP designed to identify?

SMART-COP helps identify patients who may need ICU respiratory or vasopressor support.

### What should I do if the scores disagree?

Review the individual results and favor the more conservative disposition, with clinical judgment and local guidance.

## Related tools

- [Formula / Chart Heavy PDF Analyzer](https://elysiatools.com/en/tools/formula-chart-heavy-pdf-analyzer): Compare local and hybrid OpenDataLoader extraction to identify PDF pages where formulas, charts, or dense visuals may need AI-assisted parsing
- [Image Color Extractor](https://elysiatools.com/en/tools/image-color-extractor): Extract dominant colors from images using various algorithms including k-means clustering and histogram analysis
- [Caprini Score (VTE Risk, 2005)](https://elysiatools.com/en/tools/caprini-score): Calculate the 2005 Caprini Risk Assessment Model to stratify venous thromboembolism (VTE) risk in surgical patients. ~40 items weighted 1/2/3/5 points: 1 point (age 41-60, minor surgery, BMI >25, swollen legs, varicose veins, pregnancy/postpartum, recurrent miscarriage, OCP/HRT, sepsis <1mo, lung disease/pneumonia <1mo, COPD, acute MI, CHF <1mo, bedridden, medical bed rest, IBD); 2 points (age 61-74, arthroscopic surgery, major open surgery >45min, laparoscopic >45min, malignancy, bed >72h, plaster cast, central line); 3 points (age ≥75, personal/family VTE history, factor V Leiden, prothrombin 20210A, lupus anticoagulant, anticardiolipin, homocysteine, HIT, other thrombophilia); 5 points (stroke <1mo, elective major lower-extremity arthroplasty, hip/pelvis/leg fracture <1mo, acute spinal cord injury <1mo, multiple trauma <1mo). Management tiers: 0 lowest, 1-4 low-moderate (mechanical), 5-6 high (consider LMWH 7-10d), 7-8 high (LMWH 7-10d), ≥9 highest (LMWH 30d). Derived from Caprini 2005. Not medical advice.
- [CHA₂DS₂-VASc Score (AFib Stroke Risk)](https://elysiatools.com/en/tools/chads2-vasc-score): Calculate the CHA₂DS₂-VASc score to stratify stroke risk in non-valvular atrial fibrillation and guide oral anticoagulation. Components: Congestive heart failure/LV dysfunction (+1), Hypertension (+1), Age ≥75 (+2), Diabetes (+1), prior Stroke/TIA/thromboembolism (+2), Vascular disease — prior MI/PAD/aortic plaque (+1), Age 65–74 (+1), Sex category female (+1). Range 0–9 (women) / 0–8 (men). Thresholds: men ≥2 or women ≥3 → recommend oral anticoagulation (DOAC preferred over warfarin); men 1 or women 2 → consider anticoagulation; men 0 or women ≤1 → omit. Female sex alone is not an independent risk factor (score 1 from sex alone is treated as 0). Includes an approximate annual stroke-risk estimate (Lip 2010 derivation cohort). Derived from Lip 2010 (Chest), 2019 AHA/ACC/HRS update, and 2023 ACC/AHA/ACCP/HRS AF guideline. Combine with bleeding risk (HAS-BLED) and shared decision-making. Not medical advice.
- [Charlson Comorbidity Index (Age-Adjusted)](https://elysiatools.com/en/tools/charlson-comorbidity-index): Calculate the Charlson Comorbidity Index (CCI), including the age-adjusted variant, to predict 1-year mortality from chronic comorbidities. 19 comorbidities are weighted by mortality risk: 1 point (MI, CHF, PVD, cerebrovascular disease, dementia, chronic pulmonary disease, connective tissue disease, peptic ulcer, mild liver disease, diabetes without complications); 2 points (hemiplegia/paraplegia, moderate-to-severe CKD, diabetes with end-organ damage, any non-metastatic tumor, leukemia, lymphoma); 3 points (moderate-to-severe liver disease); 6 points (metastatic solid tumor, AIDS). Age adjustment adds 1 point per decade ≥50 (50-59 +1 … ≥90 +5). Interpretation: 0 ~8%, 1-2 ~25%, 3-4 ~50%, ≥5 ~80-90% 1-year mortality (derivation cohort). Derived from Charlson 1987 (J Chronic Dis) and the 1994 validation. Not medical advice.
- [Codon to Amino Acid Translator](https://elysiatools.com/en/tools/codon-amino-acid-translator): Translate a DNA or mRNA sequence into protein using the standard genetic code. Scans all 6 reading frames (forward and reverse complement), marks start (AUG) and stop codons, identifies the longest open reading frames (ORFs), and shows the amino-acid composition with color-coded residue types. Supports T→U normalisation and reverse-complement translation.
- [Correlation Analyzer](https://elysiatools.com/en/tools/correlation-analyzer): Advanced correlation analysis tool that calculates correlation coefficients between variables to measure the strength and direction of their linear relationships. Perfect for statistical analysis, financial modeling, scientific research, and data exploration. Features: - Multiple correlation methods (Pearson, Spearman, Kendall) - Correlation matrix generation - Statistical significance testing (p-values) - Confidence intervals calculation - Heatmap visualization - Scatter plot matrix generation - Missing value handling strategies - Outlier detection and handling - Group analysis capabilities - Detailed statistical reports Common Use Cases: - Financial market analysis and risk assessment - Scientific research and hypothesis testing - Customer behavior and marketing analysis - Healthcare and medical data analysis - Quality control and process optimization - Educational performance evaluation
- [Data Boundary Processor](https://elysiatools.com/en/tools/data-boundary-processor): Advanced boundary value processing tool that identifies and handles minimum/maximum values in numerical data. Perfect for data validation, range checking, statistical analysis, and data preprocessing. Features: - Multiple boundary detection methods (absolute, percentile, standard deviation) - Flexible handling strategies (clip, remove, replace, transform) - Custom range validation - Asymmetric boundary handling - Batch processing capabilities - Comprehensive boundary statistics - Data quality assessment - Visual boundary reports Common Use Cases: - Data validation and quality control - Sensor data range checking - Financial data limit enforcement - Statistical data preprocessing - Machine learning feature engineering - Database constraint validation

## Samples

- [Web Image Processing Python Samples](https://elysiatools.com/en/samples/web-image-processing-python): Web Python image processing examples using PIL/Pillow including reading, saving, resizing, and format conversion
- [Android Image Processing Java Samples](https://elysiatools.com/en/samples/android-image-processing-java): Android Java image processing examples including reading/saving images, scaling, and format conversion
- [Android Image Processing Kotlin Samples](https://elysiatools.com/en/samples/android-image-processing-kotlin): Android Kotlin image processing examples including reading/saving images, scaling, and format conversion
- [Ethereum Smart Contracts with Solidity](https://elysiatools.com/en/samples/ethereum-solidity): Comprehensive Ethereum smart contract development examples including ERC-20, ERC-721, DeFi protocols, and hardware wallet integration

## Related content

- [Audio Encoding and Format Conversion Tools](https://elysiatools.com/en/hubs/audio-convert): Compare audio format conversion, bitrate changes, sample-rate conversion, codec swaps, and export tools in one hub for delivery and archive workflows.
- [Image Format Conversion and Animated Export Tools](https://elysiatools.com/en/hubs/image-convert): Compare image format converters for JPG, PNG, GIF, AVIF, WebP, TIFF, ICO, base64, and animation-friendly exports in one hub.
- [JSON Interchange and Format Translation Tools](https://elysiatools.com/en/hubs/json-convert): Compare JSON conversion tools for CSV, YAML, TOML, GraphQL, XML, Markdown, Excel, BSON, EDN, and related structured formats in one hub.
- [Color Space Conversion Tools for Web and Print](https://elysiatools.com/en/hubs/design-convert): Curated tools for web-to-print color space conversion in one hub.