PSI Calculator

Score the Pneumonia Severity Index (PORT score) from age, comorbidities, vital signs, and labs to estimate 30-day mortality risk class and care setting for community-acquired pneumonia.

Quick Facts

Score basis
20 weighted variables, class I-V
Demographics, 5 comorbidities, 5 exam findings, 7 labs/imaging findings, from Fine et al. 1997.
Class I shortcut
Age under 50, no comorbidities, normal vitals
Patients meeting all Class I criteria skip the point tally entirely.

Your Results

Calculated
PSI total score
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Points (0 if Class I)
Risk class
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PORT class I-V
Est. 30-day mortality
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Original-cohort band
Care setting
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General guidance

Ready

Enter demographics, comorbidities, vital signs, and labs, then calculate the PSI score.

About the Pneumonia Severity Index (PSI / PORT score)

The Pneumonia Severity Index, also known as the PORT (Patient Outcomes Research Team) score, is a clinical prediction rule published by Fine and colleagues in 1997. It was built from a large derivation and validation cohort of adults with community-acquired pneumonia to estimate 30-day mortality risk and help guide the decision between outpatient treatment and hospital admission. It remains one of the two most widely used pneumonia severity tools, alongside CURB-65.

How the score is built

The rule works in two steps. Step 1 checks whether a patient meets strict low-risk (Class I) criteria: age under 50, no history of neoplastic disease, liver disease, congestive heart failure, cerebrovascular disease, or renal disease, and normal vital signs (no altered mental status, pulse under 125, respiratory rate under 30, systolic blood pressure at least 90, and temperature between 35 and 40 degrees C). Patients meeting all of these are Class I without any further points.

Everyone else moves to Step 2, a point tally that adds:

  • Demographics: age in years, minus 10 for women, plus 10 for nursing home residence.
  • Comorbidities (5): 30 points for neoplastic disease, 20 for liver disease, 10 each for congestive heart failure, cerebrovascular disease, and renal disease.
  • Exam findings (5): 20 points for altered mental status, 20 for respiratory rate 30/min or higher, 20 for systolic blood pressure under 90 mmHg, 15 for temperature under 35 or 40 degrees C or higher, and 10 for pulse 125/min or higher.
  • Labs and imaging (7): 30 points for arterial pH under 7.35, 20 for BUN 30 mg/dL or higher, 20 for sodium under 130 mmol/L, 10 for glucose 250 mg/dL or higher, 10 for hematocrit under 30%, 10 for PaO2 under 60 mmHg, and 10 for a pleural effusion on imaging.

The sum of these points places the patient into Class II (70 points or fewer), Class III (71-90), Class IV (91-130), or Class V (above 130).

Interpreting the result

Each class carries an approximate 30-day mortality rate from the original study: about 0.1% for Class I, 0.6% for Class II, 0.9% for Class III, 9.3% for Class IV, and 27% for Class V. Classes I through III are generally considered candidates for outpatient management, Class IV typically supports inpatient admission, and Class V often supports inpatient care with consideration of a higher level of monitoring. These are population-derived bands, not a guarantee for any one patient.

When to consult a professional

This tool performs the standard PSI/PORT point calculation for education and reference. It does not diagnose pneumonia, does not replace clinical judgment, and does not account for factors the rule excludes, such as social support, oxygen delivery at home, or the ability to take oral medication. Site-of-care decisions should be made by the treating clinician using this score alongside the full clinical picture.

Frequently Asked Questions

What is the Pneumonia Severity Index (PSI) or PORT score?
The Pneumonia Severity Index (PSI), also called the PORT score, is a validated clinical prediction rule published by Fine and colleagues in 1997. It stratifies adults with community-acquired pneumonia into five risk classes (I to V) using age, sex, comorbid illnesses, physical exam findings, and laboratory results, helping clinicians estimate 30-day mortality risk and decide between outpatient care and hospital admission.
How is the PSI score calculated?
Points are added for age in years (minus 10 for women), nursing home residence, five comorbid conditions (cancer, liver disease, heart failure, cerebrovascular disease, renal disease), altered mental status, abnormal respiratory rate, blood pressure, temperature, and pulse, and seven lab and imaging findings including arterial pH, BUN, sodium, glucose, hematocrit, oxygenation, and pleural effusion. The sum places the patient into risk class II through V, or class I if strict low-risk criteria are met without needing a point total.
What do the PSI risk classes (I-V) mean?
Each class corresponds to an approximate 30-day mortality band from the original derivation and validation cohorts: class I about 0.1%, class II about 0.6%, class III about 0.9%, class IV about 9.3%, and class V about 27%. Classes I to III are generally considered candidates for outpatient management, class IV typically warrants inpatient admission, and class V often warrants inpatient care with consideration of a higher level of monitoring, always alongside clinical judgment.

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