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Emergency

CAP Severity Assessment

CURB-65 Score → Disposition Guidance

Emergency2–3 minEmergency physicians, hospitalists, primary care physicians, internists

The CURB-65 score stratifies community-acquired pneumonia severity into three risk classes that guide appropriate site of care decisions. It assesses five clinical parameters: Confusion, Urea (BUN), Respiratory rate, Blood pressure, and age ≥ 65. Patients scoring 0–1 have low 30-day mortality (~1.5%) and may be suitable for outpatient treatment. Scores of 2 indicate moderate severity warranting hospital admission. Scores ≥ 3 are associated with high mortality (>17%) and should prompt consideration of ICU admission and aggressive management. CURB-65 is endorsed by the British Thoracic Society and IDSA/ATS guidelines.

Pathway Steps

1

Community-Acquired Pneumonia Diagnosis

Confirm CAP before severity scoring

2

CURB-65 Score

Check each criterion that is present

Clinical Disclaimer

CURB-65 is a severity scoring tool and should not be the sole determinant of admission decisions. Clinical judgment, comorbidities, social circumstances, oxygenation status, and ability to tolerate oral medications must also be considered. Immunocompromised patients and nursing home residents may require more aggressive management than CURB-65 score alone suggests.