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Respiratory

Pneumonia Severity Index (PORT)

Fine et al. risk classification for CAP — 20-variable score predicting 30-day mortality.

When to use: The PSI/PORT score is used for risk stratification of community-acquired pneumonia. It is more accurate than CURB-65 but requires more data points. Class I–II patients can be treated as outpatients; Class IV–V require inpatient/ICU care.
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Formula
PSI = Age (pts) − 10 if female + nursing home (+10) + comorbidities + exam findings + labs Class I: age <50, no comorbidities, stable vitals (no calculator needed)
Key Points for NEET PG
  • PSI Class I: age <50, no comorbidities, and all 5 clinical findings negative — no formal score needed
  • PSI is more accurate than CURB-65 for identifying low-risk patients safe for outpatient treatment
  • IDSA/ATS guidelines endorse PSI for CAP severity assessment alongside CURB-65
  • pH <7.35 and BUN ≥30 are the highest-weighted lab findings (+30 and +20 respectively)
  • PSI was derived from the PORT (Pneumonia Outcomes Research Team) cohort of 38,000 patients
References
A Prediction Rule to Identify Low-Risk Patients with Community-Acquired Pneumonia · NEJM (1997)

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