BACKGROUND AND OBJECTIVE: Hospitalization for exacerbation of COPD is associated 
with a high risk of mortality. A risk-prediction model using information easily 
obtained on admission could help to identify high-risk individuals. The CURB65 
score was developed to predict mortality risk in community acquired pneumonia. A 
retrospective study found that this score was also associated with mortality in 
COPD exacerbations. We conducted a prospective study to assess the utility of 
the CURB65 score in acute COPD exacerbations.
METHODS: Consecutive patients with physician diagnosed COPD exacerbations 
admitted to a public hospital during a 1-year period were studied prospectively. 
The CURB65 scores were calculated from information obtained at initial hospital 
presentation. CURB65 = one point each for Confusion, Urea > 7 mmol/L, 
Respiratory rate ≥ 30/min, low Blood pressure, age ≥ 65 years.
RESULTS: 30-day mortality data were available for 249 of 252 patients. CURB65 
scores on admission significantly predicted risk of death during the hospital 
admission and at 30 days. The 30-day mortality by score groups were: low risk 
(scores 0-1) 2.0% (2/98), moderate risk (score 2) 6.7% (6/90) and high risk 
(scores 3-5) 21.3% (13/61). CURB65 scores were not predictive of 1-year 
mortality.
CONCLUSIONS: A simple 6-point score based on confusion, blood urea, respiratory 
rate, blood pressure and age can be used to stratify patients with COPD 
exacerbation into different management groups. The CURB65 score was as effective 
in predicting early mortality in our cohort of acute COPD exacerbations as it 
was in previous cohorts with community acquired pneumonia. Our findings suggest 
that CURB65 scores can help clinicians to assess patients with exacerbation of 
COPD.