Demographics
Gender
Age
Nursing home resident
 
Comorbid Illnesses
Neoplastic disease
Liver disease
Congestive Heart Failure
Cerebrovascular disease
Renal disease
 
Physical exam findings
Altered Mental Status
Respiratory rate > 30/min
Systolic blood pressure < 90 mmHg
Temp < 35 or > 40 degrees C
Pulse > 125./min
 
Laboratory findings
pH < 7.35
BUN > 10.7 mmol/L
Sodium < 130 mEq/L
Glucose > 13.9 mmol/L
Hematocrit < 30 %
PO2 < 60 mmHg
 
Radiographic findings
Pleural effusion
 
Total Points Risk Class
Stratification of Risk Score for Prediction Model
Risk Risk Class Based on
Low I Algorithm
Low II 70 or fewer total points
Low III 71-90 total points
Moderate IV 91-130 points
High V > 130 total points

Agency for Healthcare Research and Quality Outcomes

Infectious Diseases Society Practice Guidelines for Management Community Acquired Pneumonia

Chest x-rays: What to look for:

Two findings are associated with mortality: bilateral pleural effusions and multilobar disease.The kappa agreement for detection of these findings is modest (.46 and .51 respectively). The relative risk of bilateral pleural effusions as a predictor of mortality was 2.8 and the odds ratio of multilobar disease as a prognostic factor for mortality was 3.1
References

Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med 1997; 336:243-250. [Related Records]

Fine MJ, Hough LJ, Medsger AR, et al.The hospital admission decision for patients with community-acquired pneumonia. Results from the pneumonia Patient Outcomes Research Team cohort study. Arch Intern Med 1997; 157:36-44. [Related Records]

Fine MJ, Medsger AR, Stone RA, et al. The hospital discharge decision for patients with community-acquired pneumonia. Results from the Pneumonia Patient Outcomes Research Team cohort study. Arch Intern Med 1997; 157:47-56. [Related Records]

Fine MJ, Smith MA, Carson CA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. Jama 1996; 275:134-141. [Related Records]

Hasley PB, Albaum MN, Li YH, et al. Do pulmonary radiographic findings at presentation predict mortality in patients with community-acquired pneumonia? Arch Intern Med 1996; 156:2206-2212. [Related Records]

Albaum MN, Hill LC, Murphy M, et al. Interobserver reliability of the chest radiograph in community-acquired pneumonia. PORT Investigators. Chest 1996; 110:343-350. [Related Records]

Disclaimer: This prediction model for prognosis in patients with community-acquired pneumonia may be used to help guide the initial decision on site of care. However, its use may not be appropriate for all patients with this illness and therefore should be applied in conjunction with physician judgment. Information provided is not intended to be medical or technical advice. The information given at this site is for educational purposes only and is not sufficient for medical decisions. I disclaim any liability for the acts of any physicians or any other individual who receives any information on any medical procedure through this web site. I accept no legal responsibility for any injury and/or damage to persons or property from any of the suggestions or material discussed herein.