PSI-PORT_Pneumonia_Risk_Stratification v.1

Age

Sex

Nursing home resident

Neoplastic disease

Liver disease

Congestive heart failure

Cerebrovascular disease

Renal disease

Altered mental status

Respiratory rate ≥30/min

Systolic blood pressure <90 mmHg

Temperature <35°C or ≥40°C

Pulse ≥125/min

Arterial pH <7.35

BUN ≥30 mg/dL or ≥11 mmol/L

Sodium <130 mmol/L

Glucose ≥250 mg/dL or ≥14 mmol/L

Hematocrit <30%

Partial pressure of arterial oxygen <60 mmHg or <8 kPa

Pleural effusion on X-ray

The PSI/PORT Score is the rule and scoring system for risk stratification in patient with community acquired pneumonia.

Winner Ng

dokter.winner@gmail.com

@CambioCDS

To provide prediction rule to help physicians in making rational decisions about hospitalization for patients with community acquired pneumonia.

In step 1 of the prediction rule, the following were independently associated with mortality: -an age of more than 50 years, - each of five coexisting illnesses (neoplastic disease, congestive heart failure, cerebrovascular disease, renal disease, and liver disease), and - each of five physical examination findings (altered mental status; pulse >125 per minute; respiratory rate >30 per minute; systolic blood pressure <90 mm Hg; and temperature <35°C or >40°C). Should any of those conditions is presence, then the patient will be assigned to risk class II-IV accoding to the step 2 of the prediction rule. Otherwise, the patient is assigned to risk class 1. In step 2, in addition to the 11 factors identified in step 1, other factors are taken into consideration: - 2 demographic factors (sex and nursing home residence) , - 7 laboratory or radiographic findings (blood urea nitrogen concentration >30 mg per deciliter [11 mmol per liter]; glucose concentration >250 mg per deciliter [14 mmol per liter]; hematocrit <30 percent; sodium concentration <130 mmol per liter; partial pressure of arterial oxygen <60 mm Hg; arterial pH <7.35; and pleural effusion) All the 20 factors in step 1 and step 2 are summed to measure risk class and its magnitude of association with mortality rate. Risk Risk Class Based on Low I Rule / Algorithm Low II 70 or fewer total points Low III 71-90 total points Moderate IV 91-130 total points High V > 130 total points

- Not to be used in the presence of sepsis

1. Fine MJ. et. al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997 Jan 23;336(4):243-50. 2. Shah BA, et. al. Validity of Pneumonia Severity Index and CURB-65 Severity Scoring Systems in Community Acquired Pneumonia in an Indian Setting. The Indian Journal of Chest Diseases & Allied Sciences. 2010;Vol.52.

OBSERVATION.psi_port_score.v0, EVALUATION.psi_port_score.v0

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