II. Indications

  1. Community Acquired Pneumonia Assessment for Disposition (Outpatient, Inpatient or ICU admission)

III. Criteria: Assign one point for each of positive criteria

  1. Confusion
  2. Blood Urea Nitrogen (BUN) >20 mg/dl
  3. Respiratory Rate 30 breaths/min or higher
  4. Systolic Blood Pressure <90 mmHg or Diastolic Blood Pressure <60 mmHg
  5. Age 65 years or older

IV. Interpretation

  1. Score 0-1: Outpatient management (30 day mortality <2.1%)
  2. Score 2: Inpatient management (30 day mortality 9.2%)
  3. Score 3: Intensive Care management (30 day mortality 15-40%)

V. Efficacy

  1. Poor Test Sensitivity (use other prediction tools for low scores)
  2. High Test Specificity (strongly consider ICU admission for higher scores)

VI. Disadvantages

  1. When used as a triage tool (for hospitalization), misses borderline cases (low Test Sensitivity)
  2. Does not include Hypoxia in its criteria
  3. Requires Blood Urea Nitrogen (remainder of criteria may be identified bedside)

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