Pneumonia Severity

Estimates mortality for adult patients with community-acquired pneumonia.

The CURB-65 Score includes points for confusion and blood urea nitrogen, which in the acutely ill elderly patient, could be due to a variety of factors. An alternative scoring system, SOAR, circumvents those two parameters. It uses low systolic BP (S) and poor oxygenation (PaO2:FiO2) (O), advancing age (A), high respiratory rate (R).
CURB-65 does not assign points for comorbid illness and nursing home residence, as the original study did account for many of these conditions.
A meta-analysis showed that CURB-65 performed slightly better in prediction of mortality and need for ICU management compared to the PSI.

For patients scoring high on CURB-65, it would be prudent to ensure initial triage has not missed the presence of sepsis.
While many pneumonias are actually viral in nature, typical practice is to provide a course of antibiotics given the pneumonia may be bacterial.