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Management of CAP using a validated risk score

The management of patients with community acquired pneumonia (CAP) is characterised by considerable variation in admission rates, length of hospital stay,1 and use of institutional resources2 in different settings. The Pneumonia Severity Index (PSI) is a prediction rule for the short term risk of death in patients with CAP,3 improving the efficiency of patient care.4 In the year 2000, 86% of patients with CAP presenting at the emergency department of our hospital were admitted. A retrospective analysis of the PSI scores of these patients showed that 37% of them were in low risk classes (1 and 2) based on their PSI results, so their admissions were potentially avoidable.4,5 We therefore designed a prospective study to assess the safety, feasibility, and efficacy of the PSI score for management decisions in patients with CAP. The study was approved by the local ethics committee and …