PSI

# Criteria

1. General
1. Age in years: ADD 1 point per year
2. Gender: SUBTRACT 10 points for women
3. Nursing home resident: ADD 10 points
2. Past medical history
1. Cancer: ADD 30 points
2. Liver Disease: ADD 20 points
3. CHF: ADD 10 points
4. CVA: ADD 10 points
5. Chronic Kidney Disease: ADD 10 points
3. Examination findings
1. Altered Level of Consciousness: ADD 20 points
2. Breathing Rate >30 rpm: ADD 20 points
3. Systolic BP <90>125 bpm: ADD 10 points
4. Labs: Arterial Blood Gas (ABG)
1. Arterial pH <7.35:>64 mg/dl: ADD 20 points
3. Serum Glucose >250 mg/dl: ADD 10 points
6. Labs: Blood Count
1. Hematocrit <30%:>130: Mortality 29.2% (high risk)

# Interpretation

1. Class 1-2: Outpatient management
2. Class 3: Consider short observation hospital stay
3. Class 4-5: Inpatient management

The purpose of the PSI is to classify the severity of a patient's pneumonia to determine the amount of resources to be allocated for care. Most commonly, the PSI scoring system has been used to decide whether patients with pneumonia can be treated as outpatients or as (hospitalized) inpatients. A Risk Class I pneumonia patient can be sent home on oral antibiotics. A Risk Class II-III pneumonia patient may be sent home with IV antibiotics or treated and monitored for 24 hours in hospital. Patients with Risk Class IV-V pneumonia patient should be hospitalized for treatment.