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The Pneumonia Severity Index (PSI), initially derived to predict prognosis, has been used in emergency departments to guide disposition and treatment of patients presenting with pneumonia. These authors evaluated the utility of the PSI for guiding site-of-treatment decisions and determining patient outcomes.
In a prospective, observational, controlled cohort study, investigators in France compared outcomes for 472 patients treated at eight EDs that used the PSI and 453 patients treated at eight EDs that did not. The primary outcome was the proportion of low-risk (PSI classes I–III) patients who were treated as outpatients.
The authors calculated the PSI for all patients and determined that 48.5% were at low risk. In the EDs that used the PSI,…