title: Value of the pneumonia severity index in assessment of community-acquired pneumonia.
abstract: OBJECTIVE
  The value of the Pneumonia Severity Index (PSI) in predicting the mortality of patients with community-acquired pneumonia has not been reported in Taiwan. This study investigated the value of this scoring system in estimating mortality of inpatients with community-acquired pneumonia.
  
  
  METHODS
  This was a prospective observational study of 118 inpatients and a retrospective chart review of 115 inpatients with radiographically-confirmed community-acquired pneumonia treated at a tertiary referral medical center in southern Taiwan. Patients were stratified into 5 risk classes according to PSI score. Data on demographic characteristics, comorbidities, baseline clinical and laboratory features, in-hospital mortality and length of hospital stay were analyzed.
  
  
  RESULTS
  The mortality rates according to risk classification were 0% for class I and II, 2.5% for class III, 8.2% for class IV, and 31.2% for class V. A significant correlation was found between these risk classes and medical outcome (p < 0.001). The length of hospital stay was significantly associated with risk class, and ranged from 6.3 days for class I patients to 18 days for class V (p < 0.001).
  
  
  CONCLUSIONS
  The PSI provided a useful prediction of medical outcome in patients with community-acquired pneumonia. To decrease unnecessary admission, further prospective studies are needed to determine whether outpatient therapy is appropriate for class I or class II patients with community-acquired pneumonia.
authors.affiliation: Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Chien-Chung
authors.initials: CC
authors.lastname: Lin
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Lee
authors.forename: Chiung-Zuei
authors.initials: CZ
authors.lastname: Chen
authors.forename: Yuan-Chin
authors.initials: YC
authors.lastname: Chu
authors.forename: Tsung-Jen
authors.initials: TJ
authors.lastname: Hung
authors.forename: Han-Yu
authors.initials: HY
authors.lastname: Chang
authors.forename: Tzuen-Ren
authors.initials: TR
authors.lastname: Hsiue
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D017714:Community-Acquired Infections / Q000401:mortality*; D006801:Humans; D011014:Pneumonia / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology