Austin Health DeBug Infection Prevention Program


	Improving Antibiotic Use

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References

The Pneumonia Severity Index (PSI) scoring system¹ is a tool to assist clinicians in determining severity of community-acquired pneumonia (CAP) in adults. This calculator is designed to serve as a guide to clinical decision making and is not intended to replace clinical judgement.

PSI score	PSI Risk Class	30-day mortality rate
NA	I	0.1%
< 70	II	0.6%
> 70 and <= 90	III	0.9%
> 91 and < 130	IV	9.3%
> 130	V	27%

The PSI calculator below can be used on screen or downloaded for future use (to download PSI calculator from this webpage, go to 'File' then 'Save as' to save calculator on your desktop).

To use PSI calculator:

Step 1: Are any of the following present?

patient 51 years of age or older

co-morbid illness as listed in step 2 (PSI calculator) or

physical examination findings as listed in step 2 (PSI calculator)

Yes: go to step 2; No: PSI risk class I

Step 2: PSI calculator - compute PSI score

PSI Calculator¹

Demographic factors

Co-morbid illness

Age (years)

Cerebrovascular disease

Gender

Male

Congestive heart failure

Female

Liver disease

Nursing home resident

Neoplastic disease

Altered mental status

Chronic renal disease

Physical examination

Other findings

Pulse >= 125 per min

Urea >= 11 mmol/L

pH on blood gases < 7.35

Sodium <130 mmol/L

Respiratory rate >=30

Glucose >= 14 mmol/L

Sys. blood pressure <90 mmHg

Hematocrit <30%

Temperature <35 or >=40^oC

Pleural effusion

PO₂ <60 mm Hg

O₂ saturation <90%

1. Fine et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997;336:243-50

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