American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which factor is not a CURB-65 criterion?

Fever
Age 65 years or older
Blood urea nitrogen >20 mg/dL
Confusion

The correct answer is: Fever

The CURB-65 scoring system is a clinical tool used to assess the severity of pneumonia, particularly in adults, and to help determine the need for hospitalization. The criteria included in CURB-65 are Confusion, Urea (blood urea nitrogen >20 mg/dL), Respiratory rate (30 breaths per minute or greater), Blood pressure (systolic <90 mmHg or diastolic ≤60 mmHg), and Age (65 years or older). Fever is not listed as one of the CURB-65 criteria. While fever is certainly a common sign of pneumonia and can indicate infection, the CURB-65 system specifically focuses on a combination of clinical factors that are prognostic indicators of adverse outcomes. The correct factors are more directly associated with patient stability and the risk of mortality in those diagnosed with pneumonia. Thus, fever does not fit within the established parameters of the CURB-65 scoring system. Understanding this differentiation can help clinicians use the CURB-65 tool effectively while assessing and managing patients with pneumonia.