Template:Port score: Difference between revisions
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===[[Pneumonia severity index (Port Score)]]=== | |||
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'''Classification''' | '''Classification''' | ||
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===Disposition Pathway=== | ===Disposition Pathway=== | ||
*Classes I and II: consider discharge | *Classes I and II: consider discharge | ||
*Class III: discharge verus admit based on clinical judgment | *Class III: discharge verus admit based on clinical judgment | ||
*Classes IV and V: consider admission | *Classes IV and V: consider admission | ||
===CURB-65=== | |||
{{CURB-65}} | |||
==Prognosis== | |||
*Half of patients are still symptomatic at 30 days, with a significant minority of patients experiencing chest pain, malaise or mild dyspnea even 2 to 3 months after treatment | |||
*In adults with CAP whose symptoms have resolved within 5-7 days, it is not recommended to routinely obtain follow-up chest imaging | |||
Latest revision as of 16:08, 23 February 2020
Pneumonia severity index (Port Score)
|
Risk Factors |
Points |
| Demographic Factors | |
| Age for men |
Age |
| Age for women |
Age -10 |
| Nursing home resident |
+10 |
| Coexisting Illnesses |
|
| Neoplastic disease (active) |
+30 |
| Chronic liver disease |
+20 |
| Heart Failure |
+10 |
| Cerebrovascular disease |
+10 |
| Chronic renal disease |
+10 |
| Physical Exam |
|
| AMS |
+20 |
| RR > 30/min |
+20 |
| Sys BP < 90 |
+20 |
| Temp <35 or >40 |
+15 |
| Pulse > 125 |
+10 |
| Lab and xray findings |
|
| Arterial pH < 7.35 |
+30 |
| BUN > 30 |
+20 |
| Na <130 |
+20 |
| Glucose > 250 |
+10 |
| Hematocrit <30% |
+10 |
| PaO2 < 60 or SpO2 < 90% |
+10 |
| Pleural effusion |
+10 |
Classification
| Class |
Points |
Mortality |
| I |
<51 | 0.1% |
| II |
51-70 | 0.6% |
| III |
71-90 |
0.9% |
| IV |
91-130 |
9.3% |
| V |
>130 |
27% |
Disposition Pathway
- Classes I and II: consider discharge
- Class III: discharge verus admit based on clinical judgment
- Classes IV and V: consider admission
CURB-65
- Confusion
- bUn > 19 mg/dl
- RR > 30
- BP < 90 SBP, or < 60 DBP
- Age > 65
- Approximate 30-day mortalities and Tx considerations
- +1 --> 3%, outpt tx
- +2 -->7%, inpt, possible outpt
- +3 --> 14% inpt, possible ICU
- +4-5 --> 30% ICU
Prognosis
- Half of patients are still symptomatic at 30 days, with a significant minority of patients experiencing chest pain, malaise or mild dyspnea even 2 to 3 months after treatment
- In adults with CAP whose symptoms have resolved within 5-7 days, it is not recommended to routinely obtain follow-up chest imaging