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PNEUMONIA SEVERITY

Understanding Pneumonia Severity with Your Doctor

A-DROP helps explain why a clinician may recommend tests or hospital care for pneumonia.

Updated September 10, 2026

Pneumonia severity assessed with your doctor — A-DROP

A guide used by clinicians when considering tests and hospital care for adults with pneumonia. Review the current illness and test results with your doctor. This tool does not diagnose pneumonia.

Each positive item scores one point. A total and score category are shown only when all five items are known. Answers are processed on this device and are not sent or saved.

A Age

Age 70 or older for men, or 75 or older for women?

Age alone does not determine the treatment plan.

D Dehydration / blood test

BUN at least 21 mg/dL, or dehydration present?

BUN is a blood test for urea nitrogen. A clinician assesses dehydration. Choose “Not sure” if the value or assessment is unknown.

R Breathing / oxygen

SpO₂ 90% or less, or PaO₂ 60 Torr or less?

SpO₂ is usually measured at a fingertip; PaO₂ requires an arterial blood test. Ask a clinician about uncertain readings or readings while receiving oxygen. Do not remove oxygen to use this tool.

O Orientation / awareness

A change in awareness, such as new confusion or unclear responses?

A clinician checks responsiveness and awareness of time and place. Choose “Not sure” if this is difficult to assess.

P Blood pressure

Systolic blood pressure (the upper number) 90 mmHg or less?

Use a measurement during the current illness. Choose “Not sure” if it has not been measured.

Assessment incomplete

Not yet confirmed: 5 items (Age, Dehydration / blood test, Breathing / oxygen, Orientation / awareness, Blood pressure). Unknown items have not been counted as zero.

Confirmed positive items

None confirmed so far. Some items remain unconfirmed.

Exception: septic shock is treated as very severe even with a low score. These five items cannot determine whether shock is present.

Source: Japanese Respiratory Society, Adult Pneumonia Guideline 2024, p.31 Table 1 and p.7 (Japanese PDF). Criteria checked September 10, 2026.

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