Pneumologie
CURB-65 Pneumonia Severity Score
Schweregrad einer Pneumonie und Wahl des Behandlungsortes.
Inhalt auf Englisch
CURB-65-Rechner
Ergebnis
0Punkte
Niedrig — ambulant (~0.7% 30-Tage-Mortalität)
So wendest du ihn an
- 1
Verwirrtheit beurteilen. AMT ≤8 oder jede neue Verwirrtheit zählt.
- 2
Harnstoff prüfen. Harnstoff im Blut > 7 mmol/L im Aufnahmelabor.
- 3
Atemfrequenz über 1 Minute zählen. ≥30 möglichst vor der Gabe von zusätzlichem O₂.
Wann du ihn einsetzt
Apply to all adults with confirmed or suspected community-acquired pneumonia to guide site-of-care decisions. Not validated for hospital-acquired pneumonia or in patients with structural lung disease.
- Triage der CAP in Notaufnahme/Aufnahmestation
- Leitet die Entscheidung zwischen ambulant, Normalstation und IMC/Intensivstation.
- Deeskalation der Antibiotika
- Eine Verbesserung auf CURB 0–1 unterstützt die Umstellung auf orale Therapie.
- Nicht bei HAP oder Immunsuppression
- Andere Risikoprofile erfordern einen anderen Score.
Über den Score
CURB-65 is the British Thoracic Society (BTS) validated severity scoring system for community-acquired pneumonia (CAP) in adults. It uses five variables to stratify patients into three risk groups, directly guiding site-of-care decisions: outpatient treatment, hospital admission, or HDU/ICU consideration. The five criteria — new confusion, raised urea, elevated respiratory rate, low blood pressure, and age ≥65 — each score one point, giving a maximum of 5. CURB-65 is simpler than the PSI/PORT score and is the preferred tool in UK clinical practice, endorsed by BTS and NICE.
Confusion, Urea, Respiratory rate, Blood pressure, Age ≥65
Häufige Fragen
What CURB-65 score requires hospital admission?
A CURB-65 score of ≥2 indicates moderate-to-high severity and requires at least hospital-supervised treatment. Scores of ≥3 mandate hospital admission. Scores of 4–5 require consideration of ICU or high-dependency unit admission due to 30-day mortality rates of 15–40%.
What is the difference between CURB-65 and PSI score for pneumonia?
CURB-65 is simpler, uses five variables, and is the BTS/NICE preferred tool in the UK. The Pneumonia Severity Index (PSI/PORT) uses 20 variables and is more accurate at identifying very-low-risk patients suitable for outpatient treatment. PSI is preferred in North American practice (IDSA/ATS guidelines).
