Renaud et al developed a model for evaluating a patient with community-acquired pneumonia (CAP). This can identify patients at increased risk who may need to be admitted to the intensive care unit (ICU). The authors are from multiple institutions, primarily in France and Spain.
Parameters:
(1) age
(2) gender
(3) number of comorbid conditions
(4) respiratory rate
(5) heart rate
(6) chest X-ray findings
(7) white blood cell count
(8) arterial pH
(9) oxygen saturation or PaO2
(10) serum urea
(11) serum sodium
|
Parameter |
Finding |
Points |
|
age |
>= 80 years of age |
0 |
|
|
< 80 years of age |
1 |
|
gender |
female |
0 |
|
|
male |
1 |
|
number of comorbid conditions |
0 |
0 |
|
|
1 or more |
1 |
|
respiratory rate |
< 30 breaths per minute |
0 |
|
|
>= 30 breaths per minute |
1 |
|
heart rate |
< 125 beats per minute |
0 |
|
|
>= 125 beats per minute |
1 |
|
chest X-ray findings |
normal or single lobe infiltrate |
0 |
|
|
multilobar infiltrate and/or pleural effusion |
2 |
|
white blood cell count |
< 3,000 per µL |
1 |
|
|
3,000 to 19,999 per µL |
0 |
|
|
>= 20,000 per µL |
1 |
|
arterial pH |
>= 7.35 |
0 |
|
|
< 7.35 |
2 |
|
oxygen saturation or PaO2 |
oxygen saturation >= 90% AND PaO2 >= 60 mm Hg |
0 |
|
|
oxygen saturation < 90% OR PaO2 < 60 mm Hg |
2 |
|
serum urea |
< 11 mmol/L |
0 |
|
|
>- 11 mmol/L |
2 |
|
serum sodium |
>= 130 mmol/L |
0 |
|
|
< 130 mmol/L |
3 |
where:
• Comorbid conditions included cancer, chronic liver disease, congestive heart failure, renal failure, coronary artery disease, chronic lung disease, and/or diabetes mellitus.
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• The higher the score the more severe the CAP.
|
Total Score |
Risk Group |
Percent in ICU in 3 Days |
|
0 to 3 |
I |
1% |
|
4 to 6 |
II |
6-7% |
|
7 or 8 |
III |
11-12% |
|
9 to 17 |
IV |
27-32% |
Specialty: Infectious Diseases, Pulmonology
