Pneumonia - Risk Stratification

Risk Stratification for Pneumonia:  Openshaw made a great point today that complicated patients like this one likely don’t fit well into commonly used scoring systems.  For less complicated patients, risk stratification with the PSI/PORT score or the CURB-65 score can be helpful in determining appropriate triage

PSI/PORT:

<51 = class I             (0.1% mortality)           Home on oral Abx ok

<70 = Class II          (0.6% mortality)            Home on oral Abx ok.  

71-90 = Class III     (1.0% mortality)            O/n admission or very close f/u

91-130 = Class IV   (10% mortality)             Hospitalize for Abx and monitoring

>130 = Class V        (27% mortality)             Hospitalize for Abx and monitoring

CURB-65: (Confusion, Uremia, Resp rate, Blood pressure, age>65)

• Score of 0 to 1 can be managed as outpatients
• Score of 2 should be admitted to a hospital ward
• Score of 3 or higher often require ICU care

(Andy Copland MD, 6/6/11)