homeback Community-acquired pneumonia severity index (PSI) for adults

 
Sex

M (0 points)

F (-10 points)
Demographic factors

 Age (1 point for each year)

Nursing home resident (10 points)
Comorbid illnesses

Neoplastic disease (active) (30 points)

Chronic liver disease (20 points)

Heart failure (10 points)

Cerebrovascular disease (10 points)

Chronic renal disease (10 points)
Physical examination findings

Altered mental status (20 points)

Respiratory rate ≥30/minute (20 points)

Systolic blood pressure <90 mmHg (20 points)

Temperature <35°C (95°F) or ≥40°C (104°F) (15 points)

Pulse ≥125/minute (10 points)
Laboratory and radiographic findings

Arterial pH <7.35 (30 points)

Blood urea nitrogen ≥30 mg/dL (11 mmol/L) (20 points)

Sodium <130 mEq/L (20 points)

Glucose ≥250 mg/dL (14 mmol/L) (10 points)

Hematocrit <30 percent (10 points)

Partial pressure of arterial oxygen <60 mmHg or oxygen saturation <90 percent (10 points)

Pleural effusion (10 points)

 
Important: Inputs must be complete to perform calculation.

 
Total Criteria Point Count:
 

 
  Pneumonia score interpretation

 
 Class I 0.1% mortality
0 to 70 Points:Class II 0.6% mortality
71 to 90 Points:Class III 0.9% mortality
91 to 130 Points:Class IV 9.3% mortality
131 to 405 Points:Class V 27.0% mortality

 
Notes
  • For a patient under the age of 51 years, with no comorbidities or abnormal physical findings listed above, the PSI algorithm assigns a Class of I.

 
References
  1. Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997; 336:243-250. PubMed ID: 8995086 PubMed Logo

 
Associated Medical Subject Headings [MeSH]
 
        Adult,   Age Factors,   Aged,   Cohort Studies,   Community-Acquired Infections,   Decision Support Techniques,   Female,   Hospitalization,   Humans,   Male,   Middle Aged,   Pneumonia,   Prognosis,   ROC Curve,   Risk Factors,   Severity of Illness Index
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