Infectious Disease Respiratory Medicine Emergency Medicine A

PORT Score / PSI for Pneumonia

Pneumonia Severity Index (PSI) for stratifying CAP mortality risk. Patients in classes I–II can be treated as outpatients.

Patient age*(years)

Sex*

Nursing home resident*

Neoplastic disease*

Liver disease*

Congestive heart failure*

Cerebrovascular disease*

Renal disease*

Altered mental status*

Respiratory rate ≥30/min*

Systolic BP <90 mmHg*

Temperature <35°C or ≥40°C*

Heart rate ≥125 bpm*

Arterial pH <7.35*

BUN ≥11 mmol/L (≥30 mg/dL)*

Sodium <130 mmol/L*

Glucose ≥14 mmol/L (≥250 mg/dL)*

Haematocrit <30%*

PaO₂ <60 mmHg or SpO₂ <90%*

Pleural effusion on CXR*

Score interpretation

Class I–II (≤ 70): Low Risk -10–70

PSI ≤ 70 (class I = age ≤ 50 with no risk factors). 30-day mortality 0.1–0.7% (Fine 1997).

→ Outpatient treatment usually appropriate if clinically suitable.

Class III (71–90): Low Risk 71–90

30-day mortality 0.9–2.8% (Fine 1997).

→ Outpatient care or a short hospital stay / observation, by clinical judgement.

Class IV (91–130): Moderate Risk 91–130

30-day mortality about 8–9% (Fine 1997).

→ Hospital admission.

Class V (> 130): High Risk ≥ 131

30-day mortality about 27–31% (Fine 1997).

→ Hospital admission; assess for critical care.

Interpretation bands for the PORT/PSI. Apply clinical judgement and local guidance.

Fine MJ, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997;336(4):243-250.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.