Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Int J Tuberc Lung Dis. 2012 May;16(5):670-3. doi: 10.5588/ijtld.11.0446. Epub 2012 Mar 7.
The 2009 H1N1 influenza pandemic caused significant strain on health systems worldwide. A tool to triage patients at low risk of requiring intensive care services would assist practitioners in safely reducing hospital admission rates during pandemic influenza outbreaks. Community-acquired pneumonia severity scores have not been validated for use in pandemic influenza.
To assess the accuracy of the pneumonia severity index (PSI), CURB-65 and SMRT-CO severity scores in predicting patients at low risk of requiring intensive care services.
Between May and July 2009, 105 patients admitted with laboratory-confirmed pandemic (H1N1) 2009 influenza to Melbourne public hospitals were assessed on admission to determine their pneumonia severity scores and subsequent need for intensive care unit (ICU) support and length of stay.
SMRT-CO was the most accurate score at predicting ICU admission, with an area under the curve of the receiver operating characteristic of 0.826. No score provided good discrimination of low-risk patients, with respectively 19%, 21% and 12% requiring ICU admission as predicted by PSI, CURB-65 and SMRT-CO.
Current pneumonia severity scores have insufficient predictive ability to safely identify low-risk patients with pandemic (H1N1) 2009 influenza.
2009 年 H1N1 流感大流行给全球卫生系统带来了巨大压力。一种能够对低危需要重症监护服务的患者进行分诊的工具，将有助于临床医生在大流行流感爆发期间安全降低住院率。社区获得性肺炎严重程度评分尚未经过验证可用于大流行流感。
评估肺炎严重指数（PSI）、CURB-65 和 SMRT-CO 严重程度评分在预测低危需要重症监护服务的患者中的准确性。
2009 年 5 月至 7 月期间，对墨尔本公立医院因确诊实验室的大流行（H1N1）2009 流感而入院的 105 名患者进行评估，以确定其肺炎严重程度评分以及随后对重症监护病房（ICU）支持的需求和住院时间。
SMRT-CO 是预测 ICU 入院最准确的评分，受试者工作特征曲线下面积为 0.826。没有评分能够很好地区分低危患者，PSI、CURB-65 和 SMRT-CO 分别预测有 19%、21%和 12%的患者需要 ICU 入院。
目前的肺炎严重程度评分缺乏足够的预测能力，无法安全识别大流行（H1N1）2009 流感的低危患者。
