title: The role of pneumonia scores in the emergency room in patients infected by 2009 H1N1 infection.
abstract: Despite the severity of pneumonia in patients with pandemic influenza A infection (H1N1), no validated risk scores associated with H1N1 pneumonia were tested. In this prospective observational study, we analyzed data of consecutive patients in our emergency room, hospitalized because of pneumonia between July and August 2009 in a public hospital in Brazil. The following pneumonia scoring systems were applied: the SMART-COP rule; the Pneumonia Severity Index; and the CURB-65 rule. Of 105 patients with pneumonia, 53 had H1N1 infection. Among them, only 9.5% that had a low risk according to SMART-COP were admitted to ICU, compared with 36.8% of those with the Pneumonia Severity Index score of 1-2 and 49% of those with CURB-65 score of 0-1. The SMART-COP had an accuracy of 83% to predict ICU admission. The SMART-COP rule presented the best performance to indicate ICU admission in patients with H1N1 pneumonia.
authors.affiliation: Emergency Department, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Rodrigo Antonio
authors.initials: RA
authors.lastname: Brandão-Neto
authors.forename: Alessandra Carvalho
authors.initials: AC
authors.lastname: Goulart
authors.forename: Alfredo Nicodemos Cruz
authors.initials: AN
authors.lastname: Santana
authors.forename: Herlon Saraiva
authors.initials: HS
authors.lastname: Martins
authors.forename: Sabrina Correa Costa
authors.initials: SC
authors.lastname: Ribeiro
authors.forename: Li Y
authors.initials: LY
authors.lastname: Ho
authors.forename: Murilo
authors.initials: M
authors.lastname: Chiamolera
authors.forename: Marcelo M C
authors.initials: MM
authors.lastname: Magri
authors.forename: Augusto
authors.initials: A
authors.lastname: Scalabrini-Neto
authors.forename: Irineu Tadeu
authors.initials: IT
authors.lastname: Velasco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications* / Q000473:pathology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult