Pulmonology Book

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Severe Community Acquired Pneumonia Criteria

Aka: Severe Community Acquired Pneumonia Criteria, IDSA-ATS Minor Criteria for Severe Community Acquired Pneumonia
  1. See Also
    1. Community Acquired Pneumonia
  2. Indications
    1. Community Acquired Pneumonia assessment of ICU bed status requirement
  3. Criteria
    1. Major
      1. Invasive Mechanical Ventilation
      2. Septic Shock with Vasopressors required
    2. Minor
      1. BUN >20 mg/dl
      2. Confusion or Disorientation
      3. Hypotension requiring aggressive fluid Resuscitation
      4. Hypothermia with core Temperature <96.8 F
      5. Leukopenia with White Blood Cell Count <4000 per mm3
      6. Multilobar infiltrates
      7. PaO2 to FIO2 ratio <250 or need for Noninvasive Ventilation (NIPPV)
      8. Respiratory Rate >30 breaths/min or need for Noninvasive Ventilation (NIPPV)
      9. Thrombocytopenia with Platelet Count <100,000 per mm3
    3. Other Minor Criteria that may be considered
      1. Hypoglycemia in non-diabetic patients
      2. Acute Alcohol Withdrawal
      3. Hyponatremia
      4. Unexplained Metabolic Acidosis
      5. Elevated Lactic Acid
      6. Cirrhosis
      7. Asplenia
  4. Interpretation
    1. Overall Major and Minor Criteria
      1. ICU bed required if any major criteria is present
      2. Consider ICU bed if any minor criteria present
    2. Minor Criteria
      1. Minor score >3 is associated with a 44.1% chance of requiring an ICU admission
      2. Minor score 3 or higher is associated with 38.7% chance of needing Mechanical Ventilation or Vasopressors
  5. References
    1. Chalmers (2010) Thorax 65(10): 878-83 [PubMed]
    2. Mandell (2007) Clin Infect Dis 44(suppl 2): S27-72 [PubMed]

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