CURB-65 or CURB(S)-65 for community-acquired pneumonia?

Abstract

Background. The clinical CURB-65 score is essential for assessing severity and reducing mortality among patients with community-acquired pneumonia (CP) or at increased risk of major complications. Augmenting the existing score with oxygenation parameters (CURB(S)-65) could improve the management of these patients. Objective(s). Analysis of the specialized literature on the importance of integrating oxygenation parameters into the CURB-65 score and the benefits of the new score in the management of patients with pneumonia. Materials and methods. A systematic review of the international scientific literature was carried out using specialized electronic databases, including Google Scholar, MEDLINE, PubMed, Wiley Library, Elsevier/Mendeley, and Research4Life, covering the period 2015– 2025. The search was guided by the following keywords CURB(S)-65, CURB-65, and community-acquired pneumonia. Results. Two publications met the search criteria: one article and one abstract. In the analyzed article, patients were divided into two groups based on CURB-65 score: score 0– 1(G1) and score ≥2(G2). The mortality rate was higher in G2 patients (12.7% vs. 3.3%), and the number of patients with SaO₂<90% was also more elevated (p=0.009). Univariate analysis showed that PaO₂<60 mmHg and SaO₂<90% were associated with an increased risk of mortality. A comparative analysis of the area under the curve for the CURB-65 and CURB(S)-65 scores showed better accuracy of the CURB(S)-65 score in predicting mortality among patients with community-acquired pneumonia. Conclusion(s). The addition of oxygenation parameters to the CURB-65 score could contribute to the management of CAP by improving the accuracy of decisions on the need for intensive care unit transfer and initiation of oxygen therapy. Further studies are needed to evaluate the CURB(S)-65 score.