MDCalc

CRB-65 Score for Pneumonia Severity

Stratifies community acquired pneumonia (CAP) severity to determine inpatient versus outpatient treatment without requiring lab work.

Confusion

Respiratory rate 30/min

Blood pressure (SBP <90 mm Hg or DBP ≤60 mm Hg)

Age ≥65

Result:

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Advice
  • Interpret the score alongside a thorough clinical evaluation; low scores do not override red flags such as hypoxemia, multilobar infiltrates, severe comorbidities, immunosuppression, or poor social support.
  • Use the tool primarily for disposition; antimicrobial choice, fluids, labs, cultures, and imaging should follow guideline-based best practice and clinical judgment.
  • Although CAP can be viral, empiric antibiotics are usually prescribed to cover potential bacterial pathogens.
Management
  • Low risk (score 0): Outpatient care with timely follow-up and clear return precautions.
  • Moderate risk (score 1–2): Same-day hospital assessment; consider admission or short-stay/observation.
  • High risk (score ≥3): Urgent hospital admission and early intensive-care evaluation.
Critical Actions

Be sure to screen for other signs of sepsis and initiate appropriate management bundles; helpful tools may include (but are not limited to) SIRS, NEWS, SOFA/qSOFA.