PSI / PORT Score Calculator

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Patient age in years. Age is added directly to the score; females subtract 10 points.
years
Biological sex. Female patients receive a 10-point deduction from the age-based score.
+10 points if the patient resides in a nursing home or long-term care facility.
+30 points. Any cancer except basal-cell or squamous-cell skin cancer that was active at the time of the index illness or diagnosed within one year of presentation.
+20 points. Clinical or histological diagnosis of cirrhosis or another form of chronic liver disease.
+10 points. Systolic or diastolic ventricular dysfunction documented by history, physical exam, or chest imaging.
+10 points. Clinical diagnosis of stroke or transient ischemic attack, or stroke documented on MRI or CT.
+10 points. History of chronic renal disease or elevated serum creatinine or BUN noted in the medical record.
+20 points. Disorientation, stupor, or coma not attributed to a pre-existing condition.
+20 points. Measured respiratory rate of 30 or more breaths per minute.
+20 points. Systolic blood pressure below 90 mmHg at the time of assessment.
+15 points. Hypothermia (below 35 C / 95 F) or high fever (40 C / 104 F or above).
+10 points. Resting heart rate of 125 or more beats per minute.
+30 points. Arterial blood gas showing a pH below 7.35 (respiratory or metabolic acidosis).
+20 points. Blood urea nitrogen at or above 30 mg/dL (11 mmol/L), indicating reduced renal clearance.
+20 points. Serum sodium below 130 mmol/L (hyponatremia).
+10 points. Serum glucose at or above 250 mg/dL (14 mmol/L) in a non-diabetic context or markedly above baseline.
+10 points. Hematocrit below 30%, indicating significant anemia.
+10 points. PaO2 below 60 mmHg on arterial blood gas, or pulse oximetry below 90% on room air.
+10 points. Pleural effusion identified on chest radiograph.
PSI ScoreLow Risk
55points

Total PORT score (Class I patients score 0 by convention)

Risk ClassClass II
30-Day Mortality0.6%
DispositionOutpatient treatment with oral antibiotics
55 pts
Class II (Low)<71Class III71-91Class IV (Moderate)91-131Class V (High)131+

Class II (score 55) - Low Risk

  • The estimated 30-day mortality for Class II patients in the Fine et al. validation cohort was 0.6%.
  • Classes I and II are considered low risk. Most guidelines support outpatient management with oral antibiotics when social circumstances allow.
  • PSI/PORT should complement, not replace, clinical judgment. Factors such as inability to maintain oral intake, unstable home situation, or rapidly worsening symptoms may justify admission even for lower-risk classes.

Next stepOutpatient treatment with oral antibiotics. Pairing PSI with CURB-65 captures complementary risk dimensions and is a common clinical practice.

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