Pneumonia severity index (Port Score): Difference between revisions

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== Port Score ==
==Scoring==
{{Port score}}


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


{| border="1"
==References==
|-
<references/>
|
[[Category:ID]]
<u>'''Risk Factors'''</u>
[[Category:Pulmonary]]
 
[[Category:Featured]]
| <u>'''Points<br/>'''</u>
|-
| 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/>
| <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/>
| <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/>
| <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 ===
 
{| border="1" width="172"
|-
| '''Class '''<br/>
| '''Points '''<br/>
| '''Mortality '''<br/>
|-
| I<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 ==
 
Pulm: Pneumonia (Pathogens)
 
Pulm: Pneumonia (CAP)
 
== Source ==
 
2/8/06 DONALDSON (from 'the board')
 
<br/>[[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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