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Pneumonia Severity Index (PSI/PORT) Calculator

Calculate the PSI/PORT score to stratify community-acquired pneumonia risk and guide disposition (outpatient vs inpatient vs ICU). Classes I-III can often be treated as outpatients; IV-V require hospitalization.

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Calculate the Pneumonia Severity Index (PORT Score) to stratify mortality risk and guide disposition for community-acquired pneumonia.

Ready to run the numbers?

Why: Calculate the Pneumonia Severity Index (PORT Score) to stratify mortality risk and guide disposition for community-acquired pneumonia.

How: Enter your values in the calculator fields below, keep units consistent, then run the calculation to see results and any step-by-step work shown on this page.

Run the calculator when you are ready.

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Demographics

Comorbidities

Physical Exam

Labs

Imaging

Age must be between 18-120 years

For informational purposes only — not medical advice. Consult a healthcare professional before acting on results.

The Pneumonia Severity Index (PSI), also known as the PORT score, is a validated tool that predicts 30-day mortality in community-acquired pneumonia (CAP). It uses 20 variables: demographics, comorbidities, vital signs, and labs. Classes I-III can often be treated as outpatients; IV-V require hospitalization. Class I uses an algorithm (age ≤50, no comorbidities, normal vitals) without point calculation.

20
Variables
0.1%
Class I mortality
2.8%
Class III mortality
27-31%
Class V mortality

Sources: Fine MJ NEJM 1997; IDSA/ATS 2019.

Key Takeaways

  • • Class I-II: Outpatient treatment generally safe. Oral antibiotics.
  • • Class III: Gray zone; brief observation or outpatient based on social factors.
  • • Class IV-V: Hospitalization required. IV antibiotics. Consider ICU for Class V.
  • • Female: subtract 10 from age. Class I requires algorithm (age ≤50, no comorbidities, normal vitals).

Did You Know?

🔢 Age is the largest contributor (male = years, female = years - 10).
📊 pH <7.35 and neoplasm each add 30 points—highest single factors.
💡 PSI is better at identifying low-risk patients than CURB-65.
🌍 Validated in 38,000+ patients in the original PORT study.
📈 Class I uses algorithm; no point calculation if criteria met.
🎯 Social factors (homeless, no caregiver) may require admission regardless of PSI.

How Does PSI Work?

Scoring

Sum points from 20 variables. Class I: algorithm (age ≤50, no comorbidities, normal vitals). Classes II-V: point-based.

Disposition

I-II outpatient; III observe or outpatient; IV-V inpatient. Use IDSA/ATS criteria for ICU decisions.

Antibiotics

Outpatient: amoxicillin, doxycycline, or macrolide. Inpatient: beta-lactam + macrolide or respiratory fluoroquinolone. Duration: minimum 5 days.

Expert Tips

Check Class I algorithm first—if met, no point calculation needed.
Hypoxemia (SpO2 <90%) not in PSI—assess separately for admission.
Clinical judgment overrides score; social factors matter.
Document PSI class and disposition rationale in chart.

PSI Risk Classes

ClassPointsMortalityDisposition
IAlgorithm0.1%Outpatient
II≤700.6%Outpatient
III71-900.9-2.8%Observe
IV91-1308-9%Inpatient
V>13027-31%Inpatient/ICU

Frequently Asked Questions

What is the PSI/PORT Score?

The Pneumonia Severity Index (PSI), also known as the PORT score, is a validated tool that predicts 30-day mortality in community-acquired pneumonia (CAP). It uses 20 variables including age, comorbidities, vital signs, and labs to stratify patients into 5 risk classes (I-V). Class I-II can often be treated as outpatients; IV-V require hospitalization.

How is PSI calculated?

Points are assigned: Age (male = years, female = years - 10), nursing home (+10), neoplasm (+30), liver disease (+20), CHF/CVD/renal (+10 each), altered mental status (+20), RR ≥30 (+20), SBP &lt;90 (+20), temp &lt;35 or ≥40 (+15), pulse ≥125 (+10), pH &lt;7.35 (+30), BUN ≥30 (+20), Na &lt;130 (+20), glucose ≥250 (+10), Hct &lt;30 (+10), PaO2 &lt;60 (+10), pleural effusion (+10). Class I uses an algorithm (age ≤50, no comorbidities, normal vitals).

What are the PSI risk classes?

Class I: ≤50 pts, 0.1% mortality, outpatient. Class II: 51-70, 0.6%, outpatient. Class III: 71-90, 0.9-2.8%, brief observation. Class IV: 91-130, 8-9%, inpatient. Class V: &gt;130, 27-31%, inpatient/ICU. Classes I-III can often be outpatient or brief observation; IV-V require hospitalization.

PSI vs CURB-65?

PSI uses 20 variables and is better at identifying low-risk patients for safe outpatient treatment. CURB-65 uses 5 variables (Confusion, Urea, RR, BP, age ≥65) and is simpler for bedside use. PSI is more comprehensive; CURB-65 is quicker. Use both for clinical context.

Who should use this calculator?

Emergency physicians, hospitalists, and clinicians evaluating CAP. PSI guides disposition decisions and antibiotic choice. Class I-II: oral antibiotics; IV-V: IV beta-lactam + macrolide or respiratory fluoroquinolone. Always combine with clinical judgment and social factors.

Can this replace medical advice?

No. This tool is for educational purposes only. Clinical decisions require professional assessment. Always consult a qualified healthcare provider. Do not use for self-diagnosis. Seek care for fever, cough, shortness of breath, or suspected pneumonia.

Key Statistics

20
Variables
5
Risk classes
5d
Min abx duration
30%
Class V mortality

Official Data Sources

Fine MJ NEJM 1997 ↗
Original PORT study
IDSA/ATS Guidelines ↗
CAP guidelines
PubMed CAP ↗
CAP research
CDC Pneumonia ↗
Surveillance data

⚠️ Disclaimer: This calculator is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider. Seek care for fever, cough, shortness of breath, or suspected pneumonia.

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