Emergency Department, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Eur J Emerg Med. 2012 Jun;19(3):200-2. doi: 10.1097/MEJ.0b013e328349ed85.
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.
尽管大流行性流感 A 感染（H1N1）患者的肺炎病情严重，但尚未对与 H1N1 肺炎相关的经过验证的风险评分进行测试。在这项前瞻性观察研究中，我们分析了 2009 年 7 月至 8 月期间巴西一家公立医院因肺炎住院的连续患者的资料。应用了以下肺炎评分系统：SMART-COP 规则；肺炎严重指数；和 CURB-65 规则。在 105 名患有肺炎的患者中，有 53 名患有 H1N1 感染。其中，根据 SMART-COP 评分低危的患者仅 9.5%入住 ICU，而肺炎严重指数评分 1-2 的患者为 36.8%，CURB-65 评分 0-1 的患者为 49%。SMART-COP 对预测 ICU 入院的准确性为 83%。SMART-COP 规则在预测 H1N1 肺炎患者 ICU 入院方面表现最佳。
