Pneumonia severity scores in resource poor settings

Pneumonia

Table 2 Severity scores currently used or proposed for community acquired pneumonia

Scoring system [Ref]	Demographic	Comorbidities	Exam		Physiology					Laboratory / Radiology						Details
			Mental state	Other	hr	rr	bp	T	SPO₂	Urea	FBC	ABG	Alb	Other	CXR
CURB-65 [3]	Age		✔			✔	✔			✔						1 point each for: confusion; urea >7 mmol; rr ≥30; sbp <90 or dbp ≤60; age ≥65 years.
CRB-65 [3]	Age		✔			✔	✔									As CURB-65, without urea criterion
PSI/PORT [4]	Age^a	^a	✔		✔	✔	✔	✔		✔	✔	✔	✔	✔	✔	Complex weighted sum (20 variables, stratifying outcome to 5 risk categories)
SWAT-Bp [5]	Sex			✔			✔	✔								1 point each for: male; wasting; non-ambulatory; T <35 or >38; sbp <90 or dbp <60
Sepsis score^b [6]					✔	✔	✔	✔			✔			✔		4 categories: no SIRS^c; SIRS^c; severe sepsis^d; septic shock^e
ATS 2001 [7]					✔	✔	✔	✔				✔			✔	2 categories: ICU or not
ATS-IDSA [8]			✔		✔	✔	✔	✔		✔	✔	✔			✔	2 categories: ICU or not
SMART-COP [9]	Age		✔		✔	✔	✔		✔			✔	✔		✔	Weighted sum stratifying to 2 categories: ICU or not
SCAP [10]	Age		✔			✔	✔			✔		✔			✔	Weighted sum stratifying to 2 categories: ICU or not

Note: Predecessor systems are omitted for clarity
bp, blood pressure (mmHg); sbp/dbp, systolic/diastolic blood pressure (mmHg); rr, respiratory rate (min⁻¹); hr, heart rate (min⁻¹); T, temperature (°C); SpO₂, blood oxygen saturation (%); FBC, full blood count; ABG, arterial blood gas; alb, albumin; CXR, chest radiograph; SIRS, Systemic Inflammatory Response Syndrome; ICU, intensive care unit.
^amultiple variables used
^bnot designed as a pneumonia specific score
^c2 or more of: T <36 °C or >38 °C; hr >90 min⁻¹; rr >20 min⁻¹; white cell count <4 or >12 10⁹L⁻¹
^dsepsis + evidence of organ dysfunction or hypotension
^esevere sepsis resistant to fluid resuscitation

ISSN: 2200-6133