II. Indication: Community Acquired Pneumonia
- Triages patients to outpatient or inpatient management
III. Criteria
-
General
- Age in years: ADD 1 point per year
- Gender: SUBTRACT 10 points for women
- Nursing Home resident: ADD 10 points
- Past medical history
- Cancer: ADD 30 points
- Liver Disease: ADD 20 points
- CHF: ADD 10 points
- CVA: ADD 10 points
- Chronic Kidney Disease: ADD 10 points
- Examination findings
- Altered Level of Consciousness: ADD 20 points
- Breathing Rate >30 rpm: ADD 20 points
- Systolic BP <90 mmHg: ADD 20 points
- Temperature not 95-104 F (35-40 C): Add 15 points
- Heart Rate >125 bpm: ADD 10 points
- Labs: Arterial Blood Gas (ABG)
- Labs: Serum Chemistry
- Serum Sodium <130 mEq/L: ADD 20 points
- Blood Urea Nitrogen (BUN) >64 mg/dl: ADD 20 points
- Serum Glucose >250 mg/dl: ADD 10 points
- Labs: Blood Count
- Hematocrit <30%: ADD 10 points
-
Chest XRay
- Pleural Effusion: ADD 10 points
IV. Scoring
- Class 1: Points 0: Mortality 0.1% (low risk)
- Class 2: Points <70: Mortality 0.6% (low risk)
- Class 3: Points 71-90: Mortality 2.8% (low risk)
- Class 4: Points 91-130: Mortality 8.2% (moderate risk)
- Class 5: Points >130: Mortality 29.2% (high risk)
V. Interpretation
- Class 1-2: Outpatient management
- Class 3: Consider short observation hospital stay
- Class 4-5: Inpatient management