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Mortality Prediction Tool for Patients with Community Acquired Pneumonia

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Mortality Prediction Tool for Patients with Community Acquired Pneumonia, CURB-65

  • See Also
  1. Community Acquired Pneumonia
  2. SOAR Pneumonia Score
  • Indications
  1. Community Acquired Pneumonia Assessment for Disposition (Outpatient, Inpatient or ICU admission)
  • Criteria
  • Assign one point for each of positive criteria
  1. Confusion
  2. Blood Urea Nitrogen (BUN) >20 mg/dl
  3. Respiratory Rate 30 breaths/min or higher
  4. Systolic Blood Pressure <90 mmHg or Diastolic Blood Pressure <60 mmHg
  5. Age 65 years or older
  • Interpretation
  1. Score 0-1: Outpatient management (30 day mortality <2.1%)
  2. Score 2: Inpatient management (30 day mortality 9.2%)
  3. Score 3: Intensive Care management (30 day mortality 15-40%)
  • Efficacy
  1. Poor Test Sensitivity (use other prediction tools for low scores)
  2. High Test Specificity (strongly consider ICU admission for higher scores)
  • Disadvantages
  1. When used as a triage tool (for hospitalization), misses borderline cases (low Test Sensitivity)
  2. Does not include Hypoxia in its criteria
  3. Requires Blood Urea Nitrogen (remainder of criteria may be identified bedside)
  • References
  1. Lim (2009) Thorax 64(suppl 3):1-55 [PubMed]