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Clinical reference calculator · GeraClinic

CRB-65 Pneumonia Severity Calculator

CRB-65 estimates 30-day mortality in community-acquired pneumonia from four bedside factors — Confusion, Respiratory rate ≥30, low Blood pressure and age ≥65 — without needing blood tests, to help decide on hospital referral.

Quick answer

CRB-65 scores four bedside features of community-acquired pneumonia — new Confusion, Respiratory rate 30 or more, low Blood pressure, and age 65 or over — from 0 to 4. It drops the urea blood test from CURB-65 so it can be used in the community: 0 is low risk, 1–2 intermediate, and 3–4 high risk.

CRB-65 criteria

0/ 4

Low risk (30-day mortality <1%) — generally suitable for home/outpatient management.

A CRB-65 of 0. The score drops the urea blood test from CURB-65 so it can be used without bloods (for example in primary care), and supports the admission decision alongside oxygen saturation and clinical judgement.

Validated formula

1 point for each present feature (maximum 4): Confusion (new) = 1; Respiratory rate ≥30/min = 1; low Blood pressure (systolic <90 mmHg or diastolic ≤60 mmHg) = 1; age ≥65 years = 1. Total = 0–4. Urea is omitted (vs CURB-65) so it can be applied without bloods in the community.

Interpretation

  • 0Low risk (30-day mortality <1%) — generally suitable for home/outpatient management.
  • 1–2Intermediate risk (~1–10% mortality) — consider hospital assessment/referral.
  • 3–4High risk (~10% or higher mortality; up to ~17–50% at score 3) — urgent hospital admission, consider critical care.

How to use the CRB-65 calculator

  1. 1Tick the four criteria. Tick new confusion, respiratory rate 30 or more per minute, low blood pressure (systolic under 90 or diastolic 60 or less), and age 65 or over.
  2. 2Read the score. The tool totals the points from 0 to 4.
  3. 3Use it to support referral. 0 often suits home care, 1–2 suggests considering hospital assessment, and 3–4 suggests urgent admission — alongside oxygen levels and clinical judgement.

Medical disclaimer: This is general health information, not medical advice. It does not diagnose or treat any condition, and the results are estimates based on public reference formulas. Always consult a qualified doctor about your individual health. If you think you may have a medical emergency, contact your local emergency services immediately.

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Frequently asked questions

What is the difference between CRB-65 and CURB-65?

CRB-65 omits the urea (blood) criterion so it can be applied without bloods, for example in primary care or at home. CURB-65 adds urea and is used where blood tests are available.

What CRB-65 score needs hospital admission?

Broadly, 0 can often be managed at home, 1–2 warrants considering hospital assessment, and 3–4 warrants urgent admission with consideration of critical care. A clinician decides using the whole picture.

Does CRB-65 diagnose pneumonia?

No. It assumes pneumonia is already diagnosed and estimates its severity and 30-day mortality risk to guide where care should happen.

Sources & validation

This calculator reproduces the published CRB-65 score, validated for 30-day mortality and admission triage in community-acquired pneumonia (no bloods needed).

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