TABLE 1.
Application of the Ordinal Pneumonia Severity Measure to PHIS Database
| Criteria | Criteria Adaptation to PHIS |
|---|---|
| Mild-Discharged | |
| Discharged from ED | No admission, and No revisit leading to readmission <7 d from index visit |
| Mild-Admitted | |
| Hospitalized but not meeting any further criteria | Admitted from index visit, or Admitted from revisit and No additional criteria met from the moderate or severe groups |
| Moderate | |
| Hospitalized with bolus or IV fluids | Hospitalized, and Provision of any IV fluids |
| Hospitalized with oxygen | Hospitalized, and Provision of supplemental oxygen |
| Hospitalized with broadening of antibiotics from an aminopenicillin | Hospitalized, and Provision of an aminopenicillin on day 1 and Provision of any other antibiotic through the parenteral or oral route starting after day 1 OR Hospitalized, and Provision of an aminopenicillin and another oral/intravenous antibiotic on day 1 and Discontinuation of the aminopenicillin after day 1 with continuation of another oral or intravenous antibiotic after day 1 |
| Hospitalized with a complicated pneumonia | Hospitalized, and Presence of an additional diagnosis code for that encounter (see Supplemental Table 4) |
| Hospitalized with presumed sepsis | Hospitalized, and Presence of a SIRS or sepsis diagnosis code (see Supplemental Table 4) Provision of any IV fluids |
| Severe | |
| ICU admission | Dedicated ICU flag within PHIS |
| Positive-pressure ventilation | Dedicated mechanical ventilation flag in PHIS, OR Procedure of endotracheal intubation, OR Provision of CPAP or BiPAP, OR Concomitant ICD-10 code “Z99.11” (Dependence on ventilator status) |
| Vasoactive infusion | Provision of any of the following parenteral medications: epinephrine, norepinephrine, dopamine, milrinone, dobutamine, phenylephrine, or ephedrine |
| Chest drainage | Performance of any drainage procedure of the chest, lung, pleura, bronchus or pericardium (see Supplemental Table 5) |
| ECMO | Dedicated ECMO flag within PHIS |
| Severe sepsis | Presence of an additional diagnosis code for that encounter (see Supplemental Table 4) |
| Death | Dedicated mortality flag within PHIS |
CPAP, continuous positive airway pressure; BiPAP, bilevel positive airway pressure; ECMO, extracorporeal membrane oxygenation; IV, intravenous.