The Pittsburgh Pneumonia Prognostic Index for community acquired pneumonia was developed by Fine et al in 1990 and reflects the findings in patients with community acquired pneumonia at 3 Pittsburgh hospitals.
NOTE: The authors later defined a Prediction Rule to identify low-risk patients with community-acquired pneumonia.
Parameters
(1) neoplastic disease
(2) mental status changes
(3) pneumonia etiology
(4) vital sign abnormality
(5) age in years
(6) pleuritic chest pain
|
Parameter |
Finding |
Points |
|---|---|---|
|
neoplastic disease |
absent |
0 |
|
|
present |
4 |
|
mental status changes |
absent |
0 |
|
|
present |
2 |
|
pneumonia etiology |
low risk |
0 |
|
|
high risk (see below) |
2 |
|
vital sign abnormality |
absent |
0 |
|
|
present (see below) |
2 |
|
age in years |
<= 65 years |
0 |
|
|
> 65 years |
1 |
|
pleuritic chest pain |
absent |
0 |
|
|
present |
-2 |
where
• High risk pneumonia etiology is present if (1) due to Staphylococcus species, (2) due to Gram-negative bacilli, (3) post-obstructive pneumonia, or (4) aspiration pneumonia.
• Vital sign abnormality is present if (1) systolic blood pressure < 90 mm Hg, (2) pulse > 120 beats/minute, or (3) respiratory rate > 30 per minute.
risk score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -2
• maximum score: 11
|
Risk Score Range |
Risk Class |
Risk Category |
|
-1, -2 |
I |
low risk |
|
0 |
II |
low risk |
|
1, 2, 3, 4 |
III |
moderate risk |
|
5, 6, 7 |
IV |
high risk |
|
8, 9, 10, 11 |
V |
high risk |
|
Risk Class |
Percent Admitted |
Length of Stay |
|---|---|---|
|
I |
6% |
6.7 days |
|
II |
15% |
7.2 days |
|
III |
57% |
9.0 days |
|
IV |
20% |
11.4 days (combined Classes IV and V) |
|
V |
2% |
11.4 days (combined Classes IV and V) |
Purpose: To use the Pittsburgh Pneumonia Index to predict the level of risk for a patient presenting with community acquired pneumonia.
Specialty: Infectious Diseases, Pulmonology
Objective: severity, prognosis, stage
ICD-10: J12, J13, J14, J15, J16, J17, J18,
