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

0-1

Outpatient treatment

2

brief inpatient or supervised outpatient care

3-6

hospitalization is recommended

4 or 5

consideration of ICU care

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

**

Management

<50

outpatient treatment

>90

hospitalization

70 to 90

careful application of clinical judgment

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