Stratify community-acquired pneumonia severity by 20 PSI/PORT items: classes I–V with 30-day mortality.
PSI/PORT (Pneumonia Severity Index) is the two-step Fine 1997 algorithm that decides outpatient vs inpatient management of community-acquired pneumonia. Step 1: patients ≤50 with no comorbidity and no critical findings fall into class I and are managed at home (mortality 0.1%). Step 2 sums 20 items: sex and age, comorbidities (neoplastic, liver, CHF, stroke, CKD), physical findings (mental status, RR, SBP, temperature, HR) and labs (pH, BUN, Na, glucose, hematocrit, oxygenation, pleural effusion). Classes by total score: ≤70 II (0.6%), 71–90 III (2.8%), 91–130 IV (8.2%), >130 V (29.2%). SEPAR and SEMI list PSI alongside CURB-65 as the standard triage tool in the ED.
Fine MJ, Auble TE, Yealy DM, et al. N Engl J Med 1997;336(4):243-50
Formula version: fine-1997-v1