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CURB-65 Score (Pneumonia Severity)

· 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.

Calculate the CURB-65 score to assess community-acquired pneumonia (CAP) severity and guide the site of care. Each component scores 1 point: Confusion (new-onset disorientation), Urea > 7 mmol/L (BUN > 20 mg/dL), Respiratory rate ≥ 30/min, Blood pressure (systolic < 90 OR diastolic ≤ 60 mmHg), and Age ≥ 65. Range 0–5. Interpretation: 0–1 low risk (likely outpatient; 30-day mortality ~1.5–2.4%), 2 moderate (consider admission or supervised discharge, ~9.2%), 3–5 high risk (hospital admission; consider ICU for 4–5; mortality rises to ~57% at score 5). Endorsed by the British Thoracic Society. Derived from Lim et al. 2003 (Thorax). Not medical advice.

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Key facts

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

Overview

The CURB-65 calculator scores community-acquired pneumonia severity from 0 to 5 using confusion, urea, respiratory rate, blood pressure, and age. Use the result to support decisions about outpatient care, observation, hospital admission, or possible ICU consideration; it is not medical advice.

When to use

  • Assess the severity of suspected community-acquired pneumonia in adults.
  • Review whether a low, moderate, or high CURB-65 risk category may support the planned site of care.
  • Document the five CURB-65 criteria consistently during clinical assessment.

How it works

  1. 1Select each criterion that applies: new-onset confusion, urea above 7 mmol/L or BUN above 20 mg/dL, respiratory rate of at least 30 per minute, low blood pressure, and age 65 or older.
  2. 2The calculator assigns 1 point for each selected criterion.
  3. 3It adds the points to produce a total score from 0 to 5.
  4. 4The result reports the corresponding low-, moderate-, or high-risk category and its stated care interpretation.

Use cases

  • Emergency and acute-care assessment of adults with community-acquired pneumonia.
  • Clinical documentation of pneumonia severity and site-of-care considerations.
  • Teaching and review of the CURB-65 scoring criteria for healthcare learners.

Examples

1. Older adult with hypotension and elevated urea

Clinician assessing suspected community-acquired pneumonia

Background

The patient is at least 65 years old, has elevated urea, and meets the blood-pressure criterion, but has no new confusion or respiratory rate of 30 or more.

Problem

Calculate the CURB-65 score and identify the associated risk category.

How to use

Select Urea, BP, and Age ≥ 65 years, leaving the other two criteria unchecked.

{"confusion":false,"urea":true,"respiratoryRate":false,"bloodPressure":true,"age65":true}

Outcome

The score is 3, classified as high risk. The result indicates hospital admission, with ICU consideration for scores of 4–5 or clinical deterioration.

2. Mild pneumonia with age as the only criterion

Clinician reviewing outpatient suitability

Background

The patient is 65 or older but has no new confusion, elevated urea, rapid respiratory rate, or qualifying low blood pressure.

Problem

Confirm the score when only the age criterion is present.

How to use

FAQ

What does the CURB-65 score measure?

It estimates the severity of community-acquired pneumonia and helps inform the appropriate site of care.

What are the five CURB-65 criteria?

Confusion, urea above 7 mmol/L or BUN above 20 mg/dL, respiratory rate at least 30 per minute, low blood pressure, and age 65 or older.

What is the CURB-65 score range?

The total ranges from 0 to 5, with 1 point assigned for each criterion present.

How is a score of 2 interpreted?

A score of 2 is classified as moderate risk; admission or supervised discharge should be considered.

Is CURB-65 a substitute for clinical judgment?

No. It is a decision-support score and does not replace clinical assessment or medical advice.

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Select Age ≥ 65 years and leave confusion, urea, respiratory rate, and blood pressure unchecked.

{"confusion":false,"urea":false,"respiratoryRate":false,"bloodPressure":false,"age65":true}

Outcome

The score is 1, classified as low risk and likely suitable for outpatient management when supported by the full clinical assessment.