A 72-year-old man with community-acquired pneumonia has confusion, urea 42 mg/dL, respiratory rate 28/min, blood pressure 108/64 mmHg, age over 65. What does his CURB-65 score mandate?
- A Outpatient oral antibiotics
- B Hospital admission with consideration of ICU assessment ✓
- C Home observation without antibiotics
- D Immediate intubation
Correct answer: B. Hospital admission with consideration of ICU assessment
Explanation
He scores 5: Confusion, Urea above 7 mmol/L (42 mg/dL approximates this cutoff), Respiratory rate above 30 is absent but he scores Confusion, Urea, and Blood pressure is normal, so score is 3 (confusion, urea, age). A score of 3 or more mandates hospital admission, and scores of 4 to 5 warrant ICU assessment. Intubation is decided by clinical respiratory failure, not by the score alone.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.