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.

Used in: Pneumonia

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: Low Risk 0–50

Score ≤50 (or Class I criteria met): Mortality <1%

→ Outpatient treatment

Class III: Low-Moderate Risk 51–70

Score 51–70: Mortality ~2.8%

→ Short hospital admission or close outpatient observation

Class IV: Moderate Risk 71–90

Score 71–90: Mortality ~8.2%

→ In-patient care; IV antibiotics

Class V: High Risk 91–130

Score 91–130: Mortality ~29.2%

→ Hospitalisation; ICU consideration

Class V: Very High Risk ≥ 131

Score >130: Mortality ~29.2%+

→ ICU admission; aggressive management

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

References

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.

Score interpretation

References

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