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Pneumonia Severity Index
Dec 21, 2024
•
Mark Morgan
categories:
pulmonology
infectious disease
This is a severity scale.
Prognostic decision rule for mortality rate when diagnosed with pneumonia.
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<-- Age
General & Past Medical History
no
YES
<-- Female Gender, subtract 10 points
no
YES
<-- Nursing Home Resident, add 10 points
no
YES
<-- Cancer, add 30 points
no
YES
<-- Liver Disease, add 20 points
no
YES
<-- Congestive Heart Failure, add 10 points
no
YES
<-- Cerebrovascular Accident, add 10 points
no
YES
<-- Chronic Kidney Disease, add 10 points
Examination Findings
no
YES
<-- Altered Level of Consciousness, add 20 points
no
YES
<-- Breathing Rate >30 rpm, add 20 points
no
YES
<-- Systolic BP <90 mmHg, add 20 points
no
YES
<-- Temperature not 95-104 F (35-40 C), add 15 points
no
YES
<-- Heart Rate >125 bpm, add 10 points
Labs & Xray
no
YES
<-- ABG: Arterial pH <7.35, add 30 points
no
YES
<-- ABG: PaO2 <60 mmHg (<90% O2 Sat), add 10 points
no
YES
<-- Serum Sodium <130 mEq/L, add 20 points
no
YES
<-- Blood Urea Nitrogen (BUN) >64 mg/dl, add 20 points
no
YES
<-- Serum Glucose >250 mg/dl, add 10 points
no
YES
<-- Hematocrit <30%, add 10 points
no
YES
<-- Chest XRay: Pleural Effusion, add 10 points
Score -->
Score
score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14)+(Q15)+(Q16)+(Q17)+(Q18)+(Q19)+(Q20)
Interpretation -->
Interpretation
score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14)+(Q15)+(Q16)+(Q17)+(Q18)+(Q19)+(Q20);score>130?'Mortality 29.2% (high risk) - Inpatient management recommended. ':score>90?'Class IV: Mortality 8.2% (moderate risk) - Inpatient management recommended. ':score>70?'Class III: Mortality 2.8% (low risk) - Consider short observation hospital stay. ':score>0?'Class II: Mortality 0.6% (low risk) - Outpatient management recommended. ':'Class I: Mortality 0.1% (low risk) - Outpatient management recommended. '
display/hide references
references:
#1
Fine (1997) N Engl J Med 336: 243-50.
#2
Ebell (2006) Am Fam Physician 73: 1425-8.
#3
Family Practice Notebook Page
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