폐렴의 입원 기준 : CURB-65, Pneumonia severity index, clinical pulmonary infection score

1. CURB-65

 

외래에서 간단히 시행하기에 적합

 

 

confusion	0
urea higher than 7 mmol/L Or BUN more than 20 mg/dL	0
respiratory rate of 30/min or more	0
low systolic (<90 mm Hg) or diastolic (≤60 mm Hg) blood pressure	0
age 65 years or older	0
Total Score	0

 

각 항목당 점수 1점씩 매김

 

 

0-1	Outpatient treatment
2	brief inpatient or supervised outpatient care
3-6	hospitalization is recommended
4 or 5	consideration of ICU care

 

 

2. Pneunomia severity index

 

 

DEMOGRAPHIC FACTORS
Males	Age (yr)  60
Females	Age (yr) − 10
Nursing home residents	Age (yr) + 10
COMORBID ILLNESSES
Neoplastic disease	+30
Liver disease	+20
Congestive heart failure	+10
Cerebrovascular disease	+10
Renal disease	+10

 

 

PHYSICAL EXAMINATION FINDINGS
Altered mental status	+20
Respiratory rate 30/min or greater	+20
Systolic blood pressure <90 mm Hg	+20
Temperature <35° C or ≥40° C	+15
Pulse 125/min or greater	+10
LABORATORY FINDINGS
pH <7.35	+30
BUN >10.7 mmol/L	+20
Sodium <130 mEq/L	+20
Glucose >13.9 mmol/L	+10
Hematocrit <30%	+10
P o 2 <60 mm Hg or O 2 saturation <90%	+10
Pleural effusion	+10
Total score	**

 

이것 역시 점수를 매겨서

 

 

Management
<50	outpatient treatment
>90	hospitalization
70 to 90	careful application of clinical judgment

 

3. CPIS (clinical pulmonary infection score)

 

CPIS POINTS	0	1	2
Temperature, °C	≥36.1 and ≤38.4	≥38.5 and ≤38.9	≤36 or ≥39
White blood cell count, per 10 9 /L	≥4 and ≤11	≤3.9 or ≥11.1	≥11.1 with band forms or ≥17.1
Tracheal secretions	Absent	Present but nonpurulent (white or light-yellow)	Purulent (yellow, green, or brown)
Oxygenation (PaO 2 to FiO 2 ratio)	>240		<240 and no adult respiratory distress syndrome
Chest radiograph	No infiltrate	Diffuse or patchy infiltrate	Localized infiltrate
Tracheal aspirate culture result (semiquantitative growth amount)	None (0)	Moderate (1+ or 2+)	Heavy (3+)
Total Score

 

이것도 총점이 6 이상이어야 임상적으로 폐렴에 속함