Clinical Overview
The Pneumonia Severity Index (PSI), often referred to as the PORT score, is a comprehensive risk stratification tool. It is widely considered the most rigorously validated tool for predicting 30-day mortality in community-acquired pneumonia.
Pathophysiology & Evidence
The PSI accounts for 20 distinct variables. It heavily weights age and gender, and then adds specific penalties for underlying organ dysfunction (e.g., heart failure, renal disease) and acute physiological collapse (e.g., extreme tachypnea, severe acidosis, hypoxia).
Formula Breakdown
Score = Demographics + Comorbidities + Physical Exam Findings + Lab Results
Patients are stratified into Risk Classes I through V. Classes I and II have a mortality rate <1% and are treated as outpatients. Class V carries a mortality rate up to 27% and requires ICU admission.