How are PSI risk classes interpreted?

Class I: Age ≤ 50, no comorbidities (~0.1% mortality), outpatient. Class II (≤ 70 points): ~0.6% mortality, outpatient. Class III (71–90 points): ~2.8% mortality, brief observation/outpatient. Class IV (91–130 points): ~8.2% mortality, inpatient. Class V (> 130 points): ~29.2% mortality, inpatient/ICU.

How does PSI/PORT compare to CURB-65?

PSI/PORT uses 20 variables and better identifies low-risk patients safe for outpatient management, potentially reducing unnecessary hospitalizations. CURB-65 uses only 5 variables and is simpler to calculate at the bedside. PSI may underestimate severity in young patients without comorbidities; CURB-65 may underestimate severity in elderly patients with comorbidities.

PSI/PORT-Score — Pneumonie-Schwereindex

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What Is the PSI/PORT Score?

The Pneumonia Severity Index (PSI), derived from the Pneumonia Patient Outcomes Research Team (PORT) cohort study, is a validated clinical prediction rule for 30-day mortality in community-acquired pneumonia. Unlike CURB-65, which relies on 5 simple variables, PSI incorporates 20 variables including demographics, comorbidities, vitals, and labs. This makes it more cumbersome to calculate manually but significantly more accurate at discriminating low-risk patients.

Why Use PSI over CURB-65?

The 2019 ATS/IDSA guidelines prefer PSI over CURB-65 for determining the site of care (outpatient vs inpatient). PSI identifies a larger proportion of low-risk patients who can be safely treated as outpatients, potentially reducing unnecessary hospital admissions. CURB-65 is easier to remember but may overestimate risk in elderly patients.

🔑 Klinische Praxistipps

Age is a major driver of the score (Points = Age in years). This reflects the strong association between age and pneumonia mortality.
Women get a -10 point adjustment, reflecting lower risk compared to age-matched men.
The score heavily weights physiologic derangement (pH < 7.35 is +30 points).
Don't overlook "social admission" needs — a Class I patient who cannot take oral meds or lacks home support still needs admission.

PSI/PORT-Score (Pneumonie-Schwereindex)

Demographics

Comorbidities

Physical Exam Findings

Labs / Imaging

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What Is the PSI/PORT Score?

Why Use PSI over CURB-65?

🔑 Klinische Praxistipps

PSI/PORT-Score (Pneumonie-Schwereindex)

Demographics

Comorbidities

Physical Exam Findings

Labs / Imaging

Über dieses Tool

What Is the PSI/PORT Score?

Why Use PSI over CURB-65?

🔑 Klinische Praxistipps

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