Pneumonia Severity Index
Info
Age (years)
Gender Male Female
Nursing-home resident Yes No
~Co-existing illnesses
Neoplastic disease Present Not present
Liver disease Present Not present
Congestive heart failure Present Not present
Cerebrovascular disease Present Not present
Renal disease Present Not present
~Physical examination findings
Altered mental status Yes No
Respiratory rate >=30 breaths/min Yes No
Systolic blood pressure < 90 mm Hg Yes No
Temperature < 35°C (95°F) or >=40°C (104°F) Yes No
Pulse >= 125 beats/min Yes No
~Laboratory and radiographic findings (if study performed)
Arterial blood pH < 7.35 Yes No Test not performed
Blood urea nitrogen level >=30 mg/dL Yes No Test not performed
Sodium level < 130 mmol/L Yes No Test not performed
Glucose level >=250 mg/dL Yes No Test not performed
Hematocrit < 30% Yes No Test not performed
Partial pressure of arterial 0(2) < 60 mm Hg or 0(2) Sat < 90% Yes No Test not performed
Pleural effusion Yes No Test not performed
R e s u l t s
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~Co-existing illnesses
 
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~Physical examination findings
 
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~Laboratory and radiographic findings (if study performed)
 
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Class
 
Score
 
Mortality
 
Show Results
Info
Pneumonia Severity Index

The Pulmonary Index Score (PIS) presented here is that of Scarfone (reference below). This score is useful in assessing severity and response to therapy in pediatric asthma.

Asthma is defined as a syndrome with paroxysmal coughing, wheezing and dyspnea; and caused by the hyperresponsiveness of the tracheo-bronchial system to different stimuli, resulting in airway obstruction (American Thoracic Criteria).

4 items are assessed in the PIS:

  1. Respiratory Rate
  2. Wheezing
  3. Inspiratory: Expiratory Ratio
  4. Use of Respiratory Accessory Muscles

Each of these receives a score of 0-3 with a possible total score of 0-12 when summed to make the final score.

Scoring is based upon:

  1. Respiratory Rate
    • 0 points = <=30
    • 1 point = 31-45
    • 2 points = 46-60
    • 3 points = >60
  2. Wheezing
    • 0 points = None
    • 1 point = End expiration
    • 2 points = Entire expiration
    • 3 points = Inspiration and expiration without stethoscope
  3. Insp: Exp Ratio
    • 0 points = 2:1
    • 1 point = 1:1
    • 2 points = 1:2
    • 3 points = 1:3
  4. Use of Respiratory Accessory Muscles *
    • 0 points = None
    • 1 point = Minimal
    • 2 points = Moderate
    • 3 points = Marked

* Assessed by observing jugular, supraclavicular, intercostal, and subcostal areas

Interpretation:

  • <3 = Mild asthma attack
  • 3-7 = Moderate asthma attack
  • >=8 = Moderate to severe asthma attack

References:

  • Amirav I, Newhouse MT. Metered-dose inhaler accessory devices in acute asthma: efficacy and comparison with nebulizers: a literature review. Arch Pediatr Adolesc Med. 1997;151(9):876-82.
  • Digiulio GA, Kercsmar CM, Krug SE, et al. Hospital treatment of asthma: lack of benefit from theophylline given in addition to nebulized albuterol and intravenously administered corticosteroid. J Pediatr. 1993;122(3):464-9.
  • Kim IK, Phrampus E, Venkataraman S, et al. Helium/oxygen-driven albuterol nebulization in the treatment of children with moderate to severe asthma exacerbations: a randomized, controlled trial. Pediatrics. 2005;116(5):1127-33.
  • Nuhoglu Y, Atas E, Nuhoglu C, et al. Acute effect of nebulized budesonide in asthmatic children. J Investig Allergol Clin Immunol. 2005;15(3):197-200.
  • Ploin D, Chapuis FR, Stamm D, et al. High-dose albuterol by metered-dose inhaler plus a spacer device versus nebulization in preschool children with recurrent wheezing: A double-blind, randomized equivalence trial. Pediatrics. 2000;106(2 Pt 1):311-7.
  • Scarfone RJ, Fuchs SM, Nager AL, et al. Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma. Pediatrics. 1993;92(4):513-8.