The 2007 Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) criteria for severe community-acquired pneumonia is a clinical tool designed for the identification and stratification of patients with severe manifestations of community-acquired pneumonia. This tool aids in the decision-making process for hospitalization and intensive care unit admission, thereby optimizing patient management and resource allocation.
The criteria consist of two categories: minor and major. The minor criteria include respiratory rate greater than 30 breaths per minute, arterial partial pressure of oxygen/fraction of inspired oxygen ratio less than 250, multilobar infiltrates, confusion or disorientation, uremia (blood urea nitrogen greater than 20 mg/dL), leukopenia (white blood cell count less than 4,000/mL due to infection alone), thrombocytopenia (platelets less than 100,000/mL), hypothermia (core temperature less than 36.8 degrees C), and hypotension requiring aggressive fluid resuscitation.
The major criteria include septic shock requiring vasopressors and respiratory failure requiring mechanical ventilation.
The severity of community-acquired pneumonia is determined by the cumulative score of these criteria. A patient is considered to have severe community-acquired pneumonia if the score is 3 or more. If the score is less than 3, the criteria for severe community-acquired pneumonia are not met. This scoring system allows for a standardized approach to the assessment of severity in community-acquired pneumonia, facilitating appropriate treatment strategies and improving patient outcomes.
Reference
Lionel A Mandell, Richard G Wunderink, Antonio Anzueto et al. Infectious Diseases Society of America / American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007 Mar 1;44 Suppl 2:S27-72.
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