🦠 CURB-65 Pneumonia Severity Simulator

Community-Acquired Pneumonia — Initial Presentation

Fever, productive cough, pleuritic pain prompt severity assessment.

• ~5–6/1000: CAP annual incidence (adults, developed nations)
• ~20%: Hospitalization rate (of diagnosed CAP cases)
• S. pneumoniae: Common pathogen (most frequent cause)
• 5: Score components (C · U · R · B · 65)

Why triage matters early

Early severity scoring guides safe, efficient treatment setting.

CURB-65 origin

Derived and validated across large UK cohort studies.

A simple bedside tool, no labs strictly required.

Assessing the Five CURB-65 Criteria

Each criterion is scored as one point, present or absent.

• AMT ≤8: Confusion test (abbreviated mental test)
• >7 mmol/L: Urea threshold (≈ BUN 19 mg/dL)
• ≥30/min: Resp. rate cutoff (tachypnea marker)
• SBP<90/DBP≤60: BP cutoff (hypotension marker)

Confusion & mental status

New disorientation signals systemic severity, not baseline dementia.

Urea and vitals

Renal stress and hemodynamic compromise both raise risk.

Each toggled criterion adds exactly one point.

Computing the Score in Real Time

Score sums to a single integer from 0 through 5.

• 0–5: Score range (integer points)
• 0.6%: Score 0 mortality (lowest risk tier)
• 14.0%: Score 3 mortality (high risk tier)
• 27.8%: Score 5 mortality (highest risk tier)

Additive point system

No weighting — each criterion contributes equally, one point.

Mortality correlation

Higher scores track closely with 30-day mortality data.

Score updates instantly as sliders move.

Mapping Score to Disposition Pathway

Score bands route patients to home, ward, or ICU.

• Outpatient: Score 0–1 (low-risk pathway)
• Consider admit: Score 2 (moderate-risk pathway)
• Hospitalize: Score 3–5 (high-risk pathway)
• Consider ICU: Score ≥3 (severe pathway)

Gauge dial logic

Needle sweeps from home zone to ward to ICU.

Clinical judgment

Score guides, but never fully replaces bedside judgment.

Score ≥3 always prompts ICU-readiness review.

Appropriate Triage vs. Under-Triage Risk

Correct disposition reduces avoidable mortality and readmission.

• ↑ mortality: Under-triage risk (delayed escalation of care)
• ↓ length of stay: Appropriate triage (right level, first time)
• worse outcomes: ICU delay effect (sepsis progression window)
• widespread: Tool adoption (guideline-endorsed worldwide)

Consequences of under-triage

Sending a high-score patient home risks rapid deterioration.

Consequences of over-triage

Unnecessary admission strains beds and inflates costs.

CURB-65 balances safety against resource use.