{
  "slug": "curb-65-score",
  "title": "CURB-65 Pneumonia Severity Score",
  "heading": "CURB-65 Score Calculator",
  "category": "fitness-health",
  "url": "https://www.revenuelab.fyi/toolbox/curb-65-score",
  "summary": "Estimate 30-day mortality risk in community-acquired pneumonia.",
  "description": "CURB-65 scores community-acquired pneumonia severity using five criteria — Confusion, Urea (BUN) over 19 mg/dL (7 mmol/L), Respiratory rate 30/min or higher, Blood pressure (systolic under 90 or diastolic 60 or below), and age 65 or older — each worth one point, to estimate 30-day mortality and guide the outpatient-versus-inpatient decision. A score of 0-1 suggests low mortality risk and often supports outpatient treatment; a score of 2 suggests consideration of short inpatient stay or closely supervised outpatient care; a score of 3 or higher suggests severe pneumonia warranting hospitalization, with 4-5 often prompting ICU-level consideration. It is a decision-support aid, not the sole determinant — social factors (ability to take oral antibiotics, follow-up access, home support), oxygen saturation, and comorbidities that CURB-65 does not capture frequently change the actual disposition decision in real practice, and CRB-65 (dropping urea) is used when a BUN result is not immediately available. This tool is for education and workflow support only — not medical advice. Always verify results with a clinician and use clinical judgment alongside your institution's protocols.",
  "formula": "1 point each: Confusion, Urea/BUN >19 mg/dL, RR ≥30, SBP <90 or DBP ≤60, Age ≥65.",
  "dateModified": "2026-09-30",
  "run_url": "https://www.revenuelab.fyi/api/public/calc?tool=curb-65-score",
  "inputs": [
    {
      "id": "confusion",
      "label": "New confusion",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+1)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "bun",
      "label": "BUN",
      "kind": "number",
      "hint": null,
      "default": 15,
      "unit": "mg/dL",
      "min": 2,
      "max": 150
    },
    {
      "id": "rr",
      "label": "Respiratory rate",
      "kind": "number",
      "hint": null,
      "default": 22,
      "unit": "/min",
      "min": 8,
      "max": 60
    },
    {
      "id": "sbp",
      "label": "Systolic BP",
      "kind": "number",
      "hint": null,
      "default": 110,
      "unit": "mmHg",
      "min": 40,
      "max": 250
    },
    {
      "id": "dbp",
      "label": "Diastolic BP",
      "kind": "number",
      "hint": null,
      "default": 70,
      "unit": "mmHg",
      "min": 20,
      "max": 150
    },
    {
      "id": "age",
      "label": "Age",
      "kind": "number",
      "hint": null,
      "default": 58,
      "unit": "years",
      "min": 1,
      "max": 110
    }
  ],
  "outputs": [
    {
      "id": "score",
      "label": "CURB-65 score",
      "format": "number",
      "hint": null,
      "primary": true
    },
    {
      "id": "risk",
      "label": "Estimated 30-day mortality risk",
      "format": "raw",
      "hint": null,
      "primary": false
    },
    {
      "id": "disposition",
      "label": "Disposition guidance",
      "format": "raw",
      "hint": null,
      "primary": false
    }
  ],
  "worked_example": {
    "inputs": [
      "New confusion: No",
      "BUN: 15 mg/dL",
      "Respiratory rate: 22 /min",
      "Systolic BP: 110 mmHg",
      "Diastolic BP: 70 mmHg",
      "Age: 58 years"
    ],
    "outputs": [
      "CURB-65 score: 0",
      "Estimated 30-day mortality risk: Low risk (~0.7% mortality)",
      "Disposition guidance: Outpatient treatment often appropriate"
    ]
  },
  "how_to": {
    "title": "How to use this",
    "steps": [
      "Enter new confusion.",
      "Enter bun (mg/dL).",
      "Enter respiratory rate (/min).",
      "Enter systolic bp (mmHg).",
      "Enter diastolic bp (mmHg).",
      "Enter age (years).",
      "Read your curb-65 score on the right — it updates as you type.",
      "Hit Share to keep the scenario or send it to someone."
    ]
  },
  "scenarios": [
    {
      "name": "Conservative",
      "description": "Lower-end numbers — what if things land soft?",
      "values": {
        "confusion": "no",
        "bun": 9,
        "rr": 13,
        "sbp": 66,
        "dbp": 42,
        "age": 58
      }
    },
    {
      "name": "Typical",
      "description": "Defaults — the most common real-world setup.",
      "values": {
        "confusion": "no",
        "bun": 15,
        "rr": 22,
        "sbp": 110,
        "dbp": 70,
        "age": 58
      }
    },
    {
      "name": "Ambitious",
      "description": "Higher-end numbers — what if things really pop?",
      "values": {
        "confusion": "no",
        "bun": 24,
        "rr": 35,
        "sbp": 176,
        "dbp": 112,
        "age": 58
      }
    }
  ],
  "limitations": [
    "Population formulas describe averages; individual bodies vary, especially at the extremes of height, age, or muscle mass.",
    "Results do not account for medical conditions, medication, or pregnancy.",
    "Use this as a directional reference, not a diagnosis — talk to a clinician before acting on it."
  ],
  "faq": [
    {
      "q": "What's the difference between CURB-65 and CRB-65?",
      "a": "CRB-65 drops the urea (BUN) criterion, making it usable at the bedside or in outpatient settings without immediate lab access, at the cost of slightly less discriminatory power. It uses the same 0-4 scoring logic across the remaining four criteria and similar disposition thresholds."
    },
    {
      "q": "Should the score alone decide admission?",
      "a": "No. CURB-65 is a decision-support aid that should be combined with clinical judgment, oxygen saturation, comorbidities, ability to tolerate oral intake, home support, and follow-up access. Many clinicians hospitalize low-CURB-65 patients who lack safe outpatient support, and treat some higher-score patients as outpatients when the elevated point is due to age alone in an otherwise well-appearing patient."
    },
    {
      "q": "Why is age 65 a full point regardless of other factors?",
      "a": "Age itself is an independent risk factor for pneumonia mortality, partly reflecting reduced physiologic reserve and higher comorbidity burden, even when other vital signs look reassuring. This is also why the score can be misleading in a robust 66-year-old versus a frail 66-year-old — clinical context still matters."
    },
    {
      "q": "What CURB-65 score typically triggers ICU consideration?",
      "a": "Scores of 4-5 are associated with high 30-day mortality and often prompt evaluation for ICU-level care, though ICU admission should also be guided by criteria like severe hypoxemia, need for vasopressors, or respiratory failure, not the CURB-65 score in isolation."
    }
  ],
  "related": [
    "https://www.revenuelab.fyi/toolbox/shock-index",
    "https://www.revenuelab.fyi/toolbox/glasgow-coma-scale",
    "https://www.revenuelab.fyi/toolbox/wells-pe-score"
  ],
  "license": "CC-BY-4.0",
  "citation": "RevenueLab — CURB-65 Pneumonia Severity Score (https://www.revenuelab.fyi/toolbox/curb-65-score)"
}