PIRO Score for Community-Acquired Pneumonia

Comorbidities (COPD or immunocompromise)

Age >70 years

Bacteraemia

Multilobar opacities on chest radiograph

Shock

Severe hypoxaemia (PaO2/FiO2 <250)

Acute respiratory distress syndrome

Acute renal failure

Result0 points

Low risk stratum; 28-day mortality about 4%.

PIRO score (0-8): 0
Risk stratum: Low

When to use

Prognostic stratification of ICU-admitted patients with community-acquired pneumonia.

Formula

One point each for: comorbidities (COPD/immunocompromise), age >70, bacteraemia, multilobar opacities, shock, severe hypoxaemia, ARDS, and acute renal failure. Strata: 0-2 low, 3 mild, 4 high, 5-8 very high.

Pearls and pitfalls

Derived specifically in ICU patients with CAP and outperformed APACHE II for 28-day mortality in that setting.

References

Rello J, et al. PIRO score for community-acquired pneumonia: a new prediction rule in ICU patients with CAP. Crit Care Med. 2009;37(2):456-62.