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Pneumonia Severity Index (PORT Score)
A pneumonia adquirida na comunidade PAC constitui a principal causa de morte no mundo. Community-acquired pneumonia CAP is the leading cause of death worldwide. Despite the vast diversity of respiratory microbiota, Streptococcus pneumoniae remains the most prevalent pathogen among etiologic agents. Despite the significant decrease in the mortality rates for lower respiratory tract infections in recent decades, CAP ranks third as a cause of death in Brazil. Since the latest Guidelines on CAP from the Sociedade Brasileira de Pneumologia e Tisiologia SBPT, Brazilian Thoracic Association were published , there have been major advances in the application of imaging tests, in etiologic investigation, in risk stratification at admission and prognostic score stratification, in the use of biomarkers, and in the recommendations for antibiotic therapy and its duration and prevention through vaccination. To review these topics, the SBPT Committee on Respiratory Infections summoned 13 members with recognized experience in CAP in Brazil who identified issues relevant to clinical practice that require updates given the publication of new epidemiological and scientific evidence.
Pneumonia severity index
Community-acquired pneumonia CAP is a common disease, representing the most frequent cause of hospital admission and mortality of infectious origin in developed countries; it also has an important impact on health expenses. It is estimated that in Spain between 1. CAP will continue to represent an important threat to patients as the number of patients at risk people with comorbid conditions and elderly ones increases 2. The site-of-care home or hospital greatly determines the extensiveness of the diagnostic evaluation, the route of antimicrobial therapy and the economical cost. But the site-of-care decision is also medically important 3,4 as hospitalization and admission to the intensive care unit ICU increases the risk of thromboembolic events and superinfection by more virulent or resistant hospital bacteria. Patients at low risk for death treated in the outpatient setting are able to resume normal activity sooner and many of them also prefer outpatient therapy 2. The decision to admit a patient with CAP in medical wards or ICU may depend on subjective clinical views and peculiarities of the local healthcare setting and different studies have demonstrated that the establishment of valid criteria for a definition of severe pneumonia would provide a more reliable basis for improving patient risk assessment and therefore help physicians in their daily practice 2,5,6.
The pneumonia severity index PSI or PORT Score is a clinical prediction rule that medical practitioners can use to calculate the probability of morbidity and mortality among patients with community acquired pneumonia. This prediction rule may help physicians make more rational decisions about hospitalization for patients with pneumonia. Mortality prediction is similar to that when using CURB The rule uses demographics whether someone is older, and is male or female , the coexistence of co-morbid illnesses, findings on physical examination and vital signs , and essential laboratory findings.