PSI/PORT Score Calculator
Calculate the Pneumonia Severity Index (PSI) or PORT Score to assess community-acquired pneumonia severity and guide treatment decisions
Demographics
Comorbidities
Physical Examination
Laboratory & Radiographic Findings
*Class I: Age < 50, no comorbidities, no concerning vital signs
What is the PSI/PORT Score Calculator?
The PSI/PORT Score Calculator is a comprehensive clinical decision tool designed to assess the severity of community-acquired pneumonia (CAP) and predict 30-day mortality risk. The Pneumonia Severity Index (PSI), also known as the PORT Score (Pneumonia Patient Outcomes Research Team), was developed by Fine et al. in 1997 as a validated prediction rule to help healthcare providers determine appropriate treatment settings for patients with pneumonia.
This PSI/PORT Score Calculator utilizes 20 clinical variables including patient demographics, comorbidities, physical examination findings, and laboratory results to stratify patients into five distinct risk classes (I-V). Each risk class corresponds to specific mortality rates and treatment recommendations, making the PSI/PORT Score Calculator an essential tool for emergency medicine physicians, hospitalists, and primary care providers managing pneumonia patients.
The PSI/PORT Score Calculator has been extensively validated across multiple healthcare settings and populations, demonstrating excellent discriminatory power for predicting clinical outcomes in community-acquired pneumonia. Healthcare professionals worldwide rely on this PSI/PORT Score Calculator to make evidence-based decisions about hospitalization, intensive care unit admission, and outpatient management of pneumonia patients.
How to Use the PSI/PORT Score Calculator
Enter Patient Demographics
Input the patient's age and gender into the PSI/PORT Score Calculator. Note that female patients receive a 10-point age adjustment (age minus 10 years) in the scoring system.
Document Comorbidities
Check all applicable comorbid conditions including neoplastic disease, liver disease, congestive heart failure, cerebrovascular disease, and renal disease.
Record Vital Signs
Enter physical examination findings including mental status, respiratory rate, blood pressure, temperature, and heart rate measurements.
Input Laboratory Values
Add available laboratory results including arterial pH, BUN, sodium, glucose, hematocrit, and arterial oxygen levels.
Review Imaging Results
Indicate presence of pleural effusion on chest imaging studies to complete the PSI/PORT Score Calculator assessment.
Calculate and Interpret
Click calculate to generate the PSI/PORT score, risk class, mortality prediction, and treatment recommendations.
PSI/PORT Score Formula and Calculation
Scoring Components
Demographics & Social Factors
- • Age (men): Age in years
- • Age (women): Age in years - 10
- • Nursing home resident: +10 points
Comorbid Conditions
- • Neoplastic disease: +30 points
- • Liver disease: +20 points
- • Congestive heart failure: +10 points
- • Cerebrovascular disease: +10 points
- • Renal disease: +10 points
Physical Examination
- • Altered mental status: +20 points
- • Respiratory rate ≥ 30/min: +20 points
- • Systolic BP < 90 mmHg: +20 points
- • Temperature < 35°C or > 40°C: +15 points
- • Heart rate ≥ 125/min: +10 points
Laboratory & Imaging
- • Arterial pH < 7.35: +30 points
- • BUN ≥ 30 mg/dL: +20 points
- • Sodium < 130 mmol/L: +20 points
- • Glucose > 250 mg/dL: +10 points
- • Hematocrit < 30%: +10 points
- • PaO2 < 60 mmHg: +10 points
- • Pleural effusion: +10 points
Real-Life PSI/PORT Score Calculator Example
Case Presentation
Patient: 72-year-old male
Presentation: Community-acquired pneumonia
Comorbidities: Congestive heart failure
Vital Signs:
- • Temperature: 38.8°C (101.8°F)
- • Heart rate: 110 bpm
- • Respiratory rate: 28/min
- • Blood pressure: 95/60 mmHg
Laboratory:
- • BUN: 35 mg/dL
- • Sodium: 128 mmol/L
- • Hematocrit: 32%
PSI/PORT Score Calculation
Score Breakdown:
- • Age (male): 72 points
- • Congestive heart failure: +10 points
- • BUN ≥ 30 mg/dL: +20 points
- • Sodium < 130 mmol/L: +20 points
Total PSI Score: 122 points
Risk Class: IV
30-day Mortality: 8.2-9.3%
Recommendation: Inpatient treatment
Key Use Cases for PSI/PORT Score Calculator
Emergency Department
Use the PSI/PORT Score Calculator to rapidly assess pneumonia patients and make disposition decisions between discharge, observation, or admission.
Hospital Medicine
Hospitalists utilize the PSI/PORT Score Calculator for risk stratification, length of stay prediction, and discharge planning decisions.
Primary Care
Primary care physicians employ the PSI/PORT Score Calculator to identify low-risk patients suitable for outpatient antibiotic therapy.
Quality Improvement
Healthcare systems use PSI/PORT Score Calculator data for pneumonia care pathways, resource allocation, and outcome benchmarking.
Critical Care
Intensivists reference PSI/PORT Score Calculator results when evaluating pneumonia patients for ICU admission and prognosis discussions.
Research Applications
Clinical researchers incorporate PSI/PORT Score Calculator assessments in pneumonia studies for patient stratification and outcome analysis.
Expert Tips for PSI/PORT Score Calculator
Clinical Context Matters
Always interpret PSI/PORT Score Calculator results within the broader clinical context, considering social factors, functional status, and patient preferences that may not be captured in the scoring system.
Laboratory Timing
Ensure laboratory values entered into the PSI/PORT Score Calculator are obtained within 24 hours of presentation for accurate risk assessment and clinical decision-making.
Age Considerations
Remember that the PSI/PORT Score Calculator heavily weights age, which may overestimate risk in healthy elderly patients while underestimating risk in younger patients with severe disease.
Documentation Quality
Accurate PSI/PORT Score Calculator results depend on complete and precise documentation of all clinical variables, particularly comorbidities and vital signs.
Serial Assessments
Consider repeating PSI/PORT Score Calculator assessments during hospitalization to monitor clinical improvement and guide step-down decisions.
Multidisciplinary Approach
Combine PSI/PORT Score Calculator results with input from nursing, pharmacy, and social work teams for comprehensive pneumonia care planning.
Frequently Asked Questions
What is the difference between PSI and PORT scores?
PSI (Pneumonia Severity Index) and PORT (Pneumonia Patient Outcomes Research Team) refer to the same scoring system. The PSI/PORT Score Calculator uses identical methodology and was developed by the PORT research team.
Can I use the PSI/PORT Score Calculator for hospital-acquired pneumonia?
No, the PSI/PORT Score Calculator was specifically developed and validated for community-acquired pneumonia. It should not be used for hospital-acquired, ventilator-associated, or healthcare-associated pneumonia.
How accurate is the PSI/PORT Score Calculator?
The PSI/PORT Score Calculator has excellent discriminatory power with a c-statistic of 0.80-0.85 for predicting 30-day mortality in multiple validation studies across diverse patient populations.
What if some laboratory values are missing?
The PSI/PORT Score Calculator can still provide useful risk stratification with missing laboratory values, though complete data improves accuracy. Focus on obtaining the most clinically relevant missing parameters.
Should I use PSI/PORT or CURB-65 for pneumonia assessment?
Both tools are validated for pneumonia severity assessment. The PSI/PORT Score Calculator provides more detailed risk stratification, while CURB-65 is simpler to calculate. Consider your clinical setting and available data.
Can the PSI/PORT Score Calculator guide antibiotic selection?
The PSI/PORT Score Calculator primarily guides treatment setting decisions rather than antibiotic selection. Use local antibiograms and pneumonia guidelines for antimicrobial therapy choices.
PSI/PORT Score Calculator: Facts and Figures
Patients in original PSI/PORT validation study
C-statistic for 30-day mortality prediction
Clinical variables included in PSI/PORT calculation
Risk classes for mortality stratification
Clinical Impact
- • Reduces unnecessary hospitalizations by 30-50%
- • Decreases healthcare costs by $1,000-3,000 per patient
- • Improves patient satisfaction with appropriate care settings
- • Supports evidence-based pneumonia management protocols
Global Adoption
- • Endorsed by major pneumonia treatment guidelines
- • Implemented in electronic health record systems
- • Used in quality improvement initiatives worldwide
- • Referenced in over 1,000 peer-reviewed publications
PSI/PORT Score Calculator vs CURB-65 Score
| Feature | PSI/PORT Score Calculator | CURB-65 Score |
|---|---|---|
| Number of Variables | 20 clinical variables | 5 clinical variables |
| Complexity | More complex, requires calculator | Simple, can calculate mentally |
| Risk Classes | 5 risk classes (I-V) | 3 risk groups (0-1, 2, 3-5) |
| Primary Use | Inpatient vs outpatient decision | Mortality risk assessment |
| Laboratory Requirements | Multiple lab values needed | BUN only |
| Best Suited For | Detailed risk stratification, resource planning | Quick bedside assessment, emergency settings |