CRB-65 rule for predicting the severity of pneumonia

Added May 7, 2020

Citation: McNally M, Curtain J, O’Brien KK, et al. Validity of British Thoracic Society guidance (the CRB-65 rule) for predicting the severity of pneumonia in general practice: systematic review and meta-analysis. British Journal of General Practice 2010; 60(579): e423-33

What is this? Some patients with COVID-19 will develop pneumonia. Existing research on the use of the CRB-65 rule to predict the severity of community-acquired pneumonia may provide information to help healthcare providers with this.

In this systematic review, the authors searched for cohort studies evaluating the validity of the CRB-65 rule as a predictor of 30-day mortality in adults, in both hospital and community settings. They did their most recent search in June 2009. They included 14 studies (397,875 patients).

What was found: In hospital settings, CRB-65 performs well in stratifying patients on the basis of the severity of their pneumonia and their 30-day mortality.

In community settings, CRB-65 appears to over-predict the probability of 30-day mortality across all strata of predicted risk, so caution is needed when applying CRB-65 to patients in general practice.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.