PSI/PORT Score

Risk stratify community-acquired pneumonia for outpatient vs inpatient vs ICU. More accurate than CURB-65 for identifying low-risk patients.

Indication

Risk stratify community-acquired pneumonia for outpatient vs inpatient vs ICU. More accurate than CURB-65 for identifying low-risk patients.

id: age; label: Age (years); type: number; placeholder: e.g. 65
id: sex; label: Sex; type: options; options: value: male; label: Male (+0); value: female; label: Female (−10)
id: nursing; label: Nursing home resident (+10); type: yesno; points: 10
id: neoplastic; label: Neoplastic disease (+30); type: yesno; points: 30
id: liver; label: Liver disease (+20); type: yesno; points: 20
id: chf; label: Congestive heart failure (+10); type: yesno; points: 10
id: cvd; label: Cerebrovascular disease (+10); type: yesno; points: 10
id: renal; label: Renal disease (+10); type: yesno; points: 10
id: ams; label: Altered mental status (+20); type: yesno; points: 20
id: rr30; label: Respiratory rate ≥30 (+20); type: yesno; points: 20
id: sbp90; label: Systolic BP <90 (+20); type: yesno; points: 20
id: temp; label: Temp <35 or ≥40°C (+15); type: yesno; points: 15
id: hr125; label: Heart rate ≥125 (+10); type: yesno; points: 10
id: ph; label: Arterial pH <7.35 (+30); type: yesno; points: 30
id: bun; label: BUN ≥30 mg/dL (+20); type: yesno; points: 20
id: na; label: Sodium <130 (+20); type: yesno; points: 20
id: glucose; label: Glucose ≥250 (+10); type: yesno; points: 10
id: hct; label: Hematocrit <30% (+10); type: yesno; points: 10
id: hypoxia; label: PaO2 <60 or SpO2 <90% (+10); type: yesno; points: 10
id: effusion; label: Pleural effusion (+10); type: yesno; points: 10

PSI is better than CURB-65 at identifying truly low-risk patients safe for outpatient treatment
CURB-65 is simpler and better at identifying high-risk patients — use both for borderline cases
Social factors (ability to take oral meds, reliable follow-up) should also guide disposition
Class I is determined by an algorithm, not a point total