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

Written by the Elysia Tools team · Last updated：2026-08-07

This tool is for informational purposes only and does not constitute medical, financial, or legal advice; consult a qualified professional for advice.

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.

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Tool usage guide

Learn when to use this tool, what it supports, and how real users apply it.

Key facts

Category
Health
Input types
number, select, checkbox
Output type
json
Sample coverage
4
API ready
Yes

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.

When to use

  • When assessing community-acquired pneumonia severity with several validated scoring systems.

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  • 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

    1. 1Enter the patient's age and sex, then select applicable clinical findings, vital-sign thresholds, laboratory results, imaging findings, and comorbidities.
    2. 2The tool calculates CURB-65, PSI/PORT, and SMART-COP from the same inputs.
    3. 3Each result includes a total score, risk category, and interpretation.
    4. 4The 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.

    Examples

    1. Severe septic pneumonia with concordant high-risk scores

    Emergency clinician

    Background

    A 70-year-old patient has new confusion, elevated urea, a respiratory rate of 32/min, systolic blood pressure of 85 mmHg, oxygen saturation of 88%, arterial pH of 7.30, multilobar infiltrates, and albumin of 3.0 g/dL.

    Problem

    Compare three severity tools to assess whether the findings consistently indicate hospital and ICU-level concern.

    How to use

    Enter age 70, select the relevant confusion, urea, respiratory-rate, blood-pressure, hypoxia, pH, multilobar infiltrate, and low-albumin findings, and leave unrelated findings unselected.

    CURB-65 criteria: confusion, urea, RR ≥30, SBP <90, and age ≥65. PSI findings: RR ≥30, SBP <90, urea-related risk, pH <7.35, and hypoxia. SMART-COP findings: SBP <90, hypoxia, multilobar infiltrate, albumin <3.5, RR ≥25, confusion, and pH <7.35.

    Outcome

    CURB-65 is 5 (high), PSI is Class V, and SMART-COP is 9 (high). The tool reports concordant high risk, supporting hospital admission and consideration of ICU care.

    2. Mild pneumonia with concordant low-risk scores

    Clinician reviewing outpatient eligibility

    Background

    A 40-year-old patient has suspected pneumonia, a respiratory rate of 22/min, no listed comorbidities, and no selected abnormal vital-sign, laboratory, or imaging findings.

    Problem

    Check whether CURB-65, PSI, and SMART-COP produce a consistent low-risk assessment.

    How to use

    Enter age 40 and male sex, then leave the clinical finding and comorbidity checkboxes unselected.

    Age: 40. Confusion: false. Urea: false. RR ≥30: false. RR ≥25: false. SBP <90: false. All other listed findings and comorbidities: false.

    Outcome

    CURB-65 is 0 (low), PSI is Class I, and SMART-COP is 0 (low). The tool reports concordant low risk and an outpatient-oriented interpretation.

    FAQ

    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.

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