Pneumonia severity index (Port Score): Difference between revisions

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==Port Score==
==Scoring==
 
{{Port score}}
===Step 1:===
Insert flow chart
 
===Step 2:===
 
{| border="1"
|
Risk Factors
| Points <br />
|-
| colspan="2" | '''Demographic Factors '''<br />
|-
| Age for men <br />
| Age <br />
|-
| Age for women <br />
| Age -10 <br />
|-
| Nursing home resident <br />
| +10 <br />
|-
| '''Coexisting Illnesses '''<br />
|
|-
| Neoplastic disease (active) <br />
| +30 <br />
|-
| Chronic liver disease <br />
| +20 <br />
|-
| Heart Failure <br />
| +10 <br />
|-
| Cerebrovascular disease <br />
| +10 <br />
|-
| Chronic renal disease <br />
| +10 <br />
|-
| '''Physical Exam '''<br />
|
|-
| AMS <br />
| +20 <br />
|-
| RR > 30/min <br />
| +20 <br />
|-
| Sys BP < 90 <br />
| +20 <br />
|-
| Temp <35 or >40 <br />
| +15 <br />
|-
| Pulse > 125 <br />
| +10 <br />
|-
| '''Lab and xray findings'''<br />
|
|-
| Arterial pH < 7.35<br />
| +30 <br />
|-
| BUN > 30 <br />
| +20 <br />
|-
| Na <130 <br />
| +20 <br />
|-
| Glucose > 250 <br />
| +10 <br />
|-
| Hematocrit <30% <br />
| +10 <br />
|-
| PaO2 < 60 or SpO2 < 90% <br />
| +10 <br />
|-
| Pleural effusion <br />
| +10 <br />
|}
 
Classification
 
{| width="172"
| '''Class '''<br />
| '''Points '''<br />
| '''Mortality '''<br />
|-
| I <br />
| <nowiki>*** </nowiki><br />
| 0.1% <br />
|-
| II <br />
| <71 <br />
| 0.6% <br />
|-
| III <br />
| 71-90 <br />
| 2.8% <br />
|-
| IV <br />
| 91-130 <br />
| 8.2% <br />
|-
| V <br />
| >130 <br />
| 29.2% <br />
|}
 
^^^Less than age 55 with no other points


==See Also==
==See Also==
*[[Pneumonia]]
*[[Pneumonia (Pathogens)]]
*[[Pneumonia (Peds)]]


Pulm: Pneumonia (Pathogens)
==References==
 
<references/>
Pulm: Pneumonia (CAP)
[[Category:ID]]
 
[[Category:Pulmonary]]
==Source==
[[Category:Featured]]
 
2/8/06 DONALDSON (from 'the board')
 
[[Category:Pulm]]

Revision as of 01:46, 28 June 2016

Scoring

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

  1. Confusion
  2. bUn > 19 mg/dl
  3. RR > 30
  4. BP < 90 SBP, or < 60 DBP
  5. 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

See Also

References

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