Pneumologie
CURB-65 Pneumonia Severity Score
Gravité de la pneumonie et choix du lieu de prise en charge.
Contenu en anglais
Calculateur CURB-65
Résultat
0points
Faible — domicile (mortalité à 30 jours ~0.7%)
Comment l’utiliser
- 1
Évaluer la confusion. Un AMT ≤8 ou toute confusion récente compte.
- 2
Doser l’urée. Urée sanguine > 7 mmol/L sur le bilan d’admission.
- 3
Compter la FR pendant 1 minute. ≥30 avant l’oxygénothérapie si possible.
Quand l’utiliser
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.
- Tri des pneumonies aiguës communautaires aux urgences
- Oriente entre ambulatoire, service et soins intensifs/réanimation.
- Désescalade antibiotique
- Une amélioration à CURB 0–1 plaide pour un relais oral.
- Pas pour les pneumonies nosocomiales ni l’immunodéprimé
- Des profils de risque différents nécessitent d’autres scores.
À propos du 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
Questions fréquentes
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).
