Utrecht Pneumonia Scoring System for a Patient Who Has Undergone Esophagectomy

van der Sluis et al reported a clinical score for post-esophagectomy pneumonia. The authors are from University Medical Center Utrecht.

Patient selection: post esophagectomy

Outcome: pneumonia

Risk factors for pneumonia:

(1) extended transthoracic procedure

(2) older age

(3) male sex

(4) history of COPD

(5) few lymph nodes removed (a large number associated with reduced risk)

Parameters for the diagnosis of pneumonia:

(1) temperature in °C

(2) white blood cell count in 10^9/L

(3) pulmonary radiography (chest X-ray)

Parameter	Finding	Points
temperature	<= 36°C	2
	36.1 to 38.4	0
	38.5 to 38.9	1
	>= 39°C	2
white blood cell count	< 4 * 10^9/L	1
	4 to 11	0
	> 11 * 10^9/L	1
chest X-ray	no infiltrate	0
	patchy infiltrate	1
	diffuse infiltrate	1
	well-circumscribed infiltrate	2

total score =

= SUM(points for all 3 parameters)

Interpretation:

• minimum score: 0

• maximum score: 6

• A diagnosis of pneumonia is made if total score >= 2 AND chest X-ray points >= 1.

• Sputum culture did not influence the decision to treat for pneumonia.

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