🫁 A-DROP Pneumonia Severity (JRS)
A-DROP is the Japanese Respiratory Society modification of CURB-65, grading community-acquired pneumonia severity from five items (0–5) to guide site-of-care decisions.
A-DROP Pneumonia Severity (JRS)
Age (male ≥ 70 / female ≥ 75)
Dehydration (BUN ≥ 21 mg/dL or clinical dehydration)
Respiratory failure (SpO2 ≤ 90% or PaO2 ≤ 60 mmHg)
Orientation disturbance (confusion)
Systolic BP ≤ 90 mmHg
When to use
Score the five items — Age (sex-specific), Dehydration, Respiratory failure, Orientation disturbance, and low blood Pressure — and sum them. Higher totals support admission or ICU referral.
How it works
Each +1: Age (male ≥ 70 / female ≥ 75); Dehydration (BUN ≥ 21 mg/dL); Respiratory failure (SpO2 ≤ 90% or PaO2 ≤ 60 mmHg); Orientation disturbance; SBP ≤ 90 mmHg. Bands: 0 mild · 1–2 moderate · 3 severe · 4–5 very severe.
Key points
- A-DROP differs from CURB-65 mainly by using sex-specific age thresholds and a BUN/clinical dehydration item instead of the urea cutoff, with comparable discrimination. (original synthesis · not guideline verbatim)
- A score of 3 supports admission and 4–5 supports ICU consideration, but the tool gives direction only.
- Integrate imaging extent, comorbidities, hypoxemia trajectory, and social factors; young patients can deteriorate despite a low score.
References
- Japanese Respiratory Society. The JRS guidelines for the management of CAP in adults. Respirology. 2006;11(Suppl 3):S79-S133.
- Shindo Y, et al. Comparison of severity scoring systems A-DROP and CURB-65 for CAP. Respirology. 2008;13(5):731-735.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.