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PSI/PORT Score: Pneumonia Severity Index for CAP
Risk class and mortality in community-acquired pneumonia.
PSI/PORT Score: Pneumonia Severity Index for CAP
Age
years
Sex
Nursing home resident
Neoplastic disease
Liver disease
Congestive heart failure
Cerebrovascular disease
Renal disease
Altered mental status
Respiratory rate >=30/min
Systolic BP <90 mmHg
Temperature <35 or >=40 C
Pulse >=125/min
Arterial pH <7.35
BUN >=30 mg/dL (urea >=11 mmol/L)
Sodium <130 mmol/L
Glucose >=250 mg/dL
Haematocrit <30%
PaO2 <60 mmHg (or SpO2 <90%)
Pleural effusion
Complete the fields above to see the result.
When to use
- Stratifying 30-day mortality risk and guiding the admission decision in community-acquired pneumonia.
Formula
Step 1: age <50, no listed comorbidity and no exam abnormality = Class I. Otherwise sum points: age (men = age, women = age - 10), nursing-home +10, comorbidities (neoplasm +30, liver +20, CHF/cerebrovascular/renal +10 each), exam (altered mental status +20, RR>=30 +20, SBP<90 +20, temp<35 or >=40 +15, pulse>=125 +10), labs/imaging (pH<7.35 +30, BUN>=30 +20, Na<130 +20, glucose>=250 +10, Hct<30 +10, PaO2<60 +10, pleural effusion +10). Class II <=70, III 71-90, IV 91-130, V >130.
Pearls and pitfalls
- Class I is assigned by the initial demographic/clinical screen before any points are totalled.
- PSI tends to be more sensitive but less practical than CURB-65 for identifying low-risk patients.