Difference between revisions of "Pneumonia severity index (Port Score)"

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Latest 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