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 (30 points)
		Liver disease (20 points)
		Congestive heart failure (10 points)
		Cerebrovascular disease (10 points)
		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 degrees C or ≥40 degrees C (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% (10 points)
		Pleural effusion (10 points)

 

Total Criteria Point Count:
 

 

Pneumonia Score Interpretation

 

	Class I 0.1% Mortality
51 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 395 Points:	Class V 27.0% Mortality

 

 

References

1. Steinberg DI. ACP Journal Club. Review: Risk prediction scales have different strengths and weaknesses for predicting mortality in community-acquired pneumonia. Ann Intern Med. 2011 Apr 19;154(8):JC4-12. doi: 10.1059/0003-4819-154-8-201104190-02012. PubMed ID: 21502638
2. Loke YK, Kwok CS, Niruban A, Myint PK. Value of severity scales in predicting mortality from community-acquired pneumonia: systematic review and meta-analysis. Thorax. 2010 Oct;65(10):884-90. doi: 10.1136/thx.2009.134072. Epub 2010 Aug 20. Review. PubMed ID: 20729235
3. Morris A. ACP Journal Club. Review: CURB65, CRB65, and Pneumonia Severity Index similarly predict mortality in community-acquired pneumonia. Ann Intern Med. 2011 Apr 19;154(8):JC4-13. doi: 10.1059/0003-4819-154-8-201104190-02013. PubMed ID: 21502639
4. Chalmers JD, Singanayagam A, Akram AR, et al. Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis. Thorax. 2010 Oct;65(10):878-83. doi: 10.1136/thx.2009.133280. Epub 2010 Aug 20. Review. PubMed ID: 20729231
5. 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