Parameters:
(1) arterial pH
(2) systolic blood pressure in mm Hg
(3) mental status
(4) age in years
(5) BUN in mg/dL
(6) respiratory rate in breaths per minute
(7) chest X-ray findings
(8) PaO2 or PaO2-to-FIO2 ratio
|
Parameter
|
Finding
|
Points
|
|
arterial pH
|
>= 7.30
|
0
|
|
|
< 7.3 (acidosis)
|
1
|
|
systolic blood pressure
|
>= 90 mm Hg
|
0
|
|
|
< 90 mm Hg
|
1
|
|
mental status
|
not confused
|
0
|
|
|
confused
|
1
|
|
age in years
|
< 80 years
|
0
|
|
|
>= 80 years
|
1
|
|
BUN
|
<= 30 mg/dL
|
0
|
|
|
> 30 mg/dL
|
1
|
|
respiratory rate
|
<= 30 breaths per minute
|
0
|
|
|
> 30 breaths per minute
|
1
|
|
chest X-ray findings
|
normal or single lobe infiltrate or single lung
|
0
|
|
|
multiple lobe infiltrate bilateral
|
1
|
|
PaO2 or PaO2-to-FIO2 ratio
|
PaO2 >= 54 mm Hg AND PaO2-to-FIO2 ratio >= 250 mm Hg
|
0
|
|
|
PaO2 < 54 mm Hg OR PaO2-to-FIO2 ratio < 250 mm Hg
|
1
|
where:
• The text refers to blood urea. The units of blood urea is mmol/L. Use of mg/dL indicates BUN.
• Several of the criteria reflect the presence of an organ failure.
number of major criteria present =
= (points for arterial pH) + (points for systolic blood pressure)
number of minor criteria present =
= SUM(points for the remaining 6 parameters)
Interpretation:
• Severe community-acquired pneumonia is defined as either >= 1 major criteria OR >= 2 minor criteria.
• A patient with severe CAP should be managed in the hospital, possibly in the intensive care unit (ICU).
