pneumonia severity index; PORT score (PSI)

Introduction

A prediction rule to identify low-risk patients with community-acquired pneumonia. Patients with a score of > 90 should be admitted to the hospital. .

• Age > 50 years: 1 point per year
• Female? Yes -10
• Nursing home resident? Yes +10
• Neoplastic disease history? Yes +30
• Liver disease? Yes +20
• CHF? Yes +10
• Cerebrovascular disease? Yes +10
• Renal disease? Yes +10
• Altered mental status? Yes +20
• Respiratory rate > 29? Yes +20
• Systolic blood pressure < 90? Yes +20
• Temperature < 35C (95F) or > 39.9C (103.8F)? Yes +15
• Pulse > 124? Yes +10
• pH < 7.35? Yes +30
• BUN > 29? Yes +20
• Sodium < 130? Yes +20
• Glucose > 249 (US) or > 13.8 (SI) ? Yes +10
• Hematocrit < 30%? Yes +10
• Partial pressure of Oxygen < 60? Yes +10
• Pleural effusion on x-ray? Yes +10

Calculator

Notes

• other criteria for hospitalization
  • age >= 65 years
  • vital signs
    • systolic BP < 90 mm Hg or diastolic BP < 60 mm Hg
    • heart rate >= 125/min
    • respirations >= 30.min
    • temperature < 35 C or >= 40 C
  • altered mental status, confusion, delirium
  • laboratory:
    • BUN > 20 mg/dL
    • WBC < 4000/uL
    • platelet count < 100,000/uL
    • PaO2/FiO2 ratio < 250
  • radiography
    • multilobular infiltrate on chest X-ray
  • comorbidities
    • malignancy
    • congestive heart failure
    • cerebrovascular disease
    • kidney disease
    • liver disease

More general terms

• numerical rating scale (NRS)