PSI / Fine

PSI / Fine — community-acquired pneumonia

Principle

Clinical class I then, if needed, weighted sum and classes II–V.

Scope

Adult community-acquired pneumonia ≥18 years. Original Fine 1997 prognostic model; clinical class I distinct from the weighted total.

Interpretation limits

30-day prognosis, not immediate stability. Even in class I, hypoxaemia must be assessed clinically and may justify hospitalisation. Oral tolerance, social context, comorbidities and medical judgement remain decisive; no automatic discharge. HIV/immunosuppression, recent hospitalisation or transfer need assessment beyond the original cohorts.

Formula and logic

Stage 1: age ≤50 years, absence of five comorbidities and five clinical abnormalities → class I without a total. Otherwise: age (−10 for female scoring) + contributions → II ≤70, III 71–90, IV 91–130, V >130.

Interpretation

8–70

Class II

71–90

Class III

91–130

Class IV

131–405

Class V

Definition version : 0.1.0

Sources

• Fine et al. · NEJM — A Prediction Rule to Identify Low-Risk Patients with Community-Acquired Pneumonia

  1997 · Figure 1: clinical class I; Table 2: age, female correction −10 and contributions; classes II–V and 30-day horizon.

• Fine et al. · reproduction du texte original — Prediction rule · Figure 1 et Tableau 2

  1997 · Tables visually read; thresholds and definitions. No interpolated individual percentage.