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¶ Scoring systems, such as the PSI and CURB-65, and clinical criteria are intended to supplement rather than override the judgment of the physician. Factors other than the predictors included in the rules and the clinical criteria may be important when making an admission decision or selecting the site of inpatient care. As examples, patients with early signs of sepsis or rapidly progressive illness are not well represented by severity scores. Patients with these features may warrant hospitalization and/or ICU admission regardless of score. Conversely, older age may be overrepresented in severity scores; this should be taken into account when determining site of care.

Δ Using the CURB-65 score, if the patient has a score of 1 because he or she is ≥65 years of age and he or she has no major comorbidities, hospital admission is not necessarily indicated.