CURB-65 Score
Estimates pneumonia mortality and guides disposition
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Emergency department, Inpatient
Calculate
Answer every item. The result uses the same scoring code Scribeable runs in notes. Nothing you enter leaves this page.
Confusion (new disorientation)
1 to 300 BUN mg/dL.
4 to 80 breaths/min.
Systolic BP below 90 or diastolic 60 mmHg or below
18 to 120 years.
Enter the values above to see the result.
When it activates
Scribeable activates a calculator from the encounter. The CURB-65 Score can activate when the transcript or pasted chart context documents any of these:
- Community-acquired pneumonia
- Pneumonia severity assessment
- Admission vs outpatient decision
- ICU consideration for pneumonia
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: J13, J14, J15, J16, J17, J18.
Note-type scope: it activates on notes whose subject resolves to pulmonology, emergency medicine, hospital medicine, critical care. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
5 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Confusion (new altered mental status) | exam | New disorientation to person, place, or time (CURB-65: 1 point). | |
| BUN >19 mg/dL | lab | mg/dL | Scored 1 point when greater than 19 mg/dL. |
| RR >=30/min | vital | /min | Scored 1 point when 30/min or greater. |
| SBP <90 or DBP <=60 | vital | mmHg | |
| Age >=65 | age | years | Scored 1 point when age 65 or older. |
Scoring
C=Confusion, U=Urea>19, R=RR>=30, B=BP low, 65=Age>=65. 1 point each.
Confusion Confusion (new altered mental status) + BUN>19 BUN >19 mg/dL + RR≥30 RR >=30/min + BP low SBP <90 or DBP <=60 + Age≥65 Age >=65
Interpretation
0-1: Low mortality (1.5%), outpatient. 2: 9.2%, consider admission. >=3: 22%, inpatient; 4-5 consider ICU.
Evidence
Sources carried in Scribeable's citation registry for this calculator.
- Lim WS et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation studyLim et al. (CURB-65) 2003 · 2003 · BTS · Level I · link last verified 2026-03-23
- ATS/IDSA Diagnosis and Treatment of Adults with Community-Acquired PneumoniaATS/IDSA CAP 2019 · 2019 · ATS/IDSA · Strong recommendation · link last verified 2026-03-23
How Scribeable handles it in the note
When an encounter activates the CURB-65 Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a CURB-65 Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a mandatory rule-out score: a missed result carries acute harm, so the activation filter never approves it on uncertainty.
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