Longziekten
CURB-65 Pneumonia Severity Score
Ernst van een pneumonie en keuze van de behandelsetting.
Inhoud in het Engels
CURB-65-calculator
Uitkomst
0punten
Laag — thuis (~0.7% mortaliteit na 30 dagen)
Hoe je hem gebruikt
- 1
Beoordeel verwardheid. AMT ≤8 of elke nieuwe verwardheid telt.
- 2
Controleer het ureum. Ureum in het bloed > 7 mmol/L bij het opnamebloed.
- 3
Tel de ademfrequentie gedurende 1 minuut. Bij voorkeur ≥30 vóór het geven van extra O₂.
Wanneer je hem gebruikt
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 van CAP op de SEH/acute opnameafdeling
- Helpt kiezen tussen poliklinisch, afdeling of medium care/IC.
- De-escalatie van antibiotica
- Verbetering naar CURB 0–1 ondersteunt overstap naar orale therapie.
- Niet bij HAP of immuungecompromitteerden
- Een ander risicoprofiel vraagt om een andere score.
Over de 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
Veelgestelde vragen
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).
