• Rodrigo Antonio Brandão-Neto, Alessandra Carvalho Goulart, Alfredo Nicodemos Cruz Santana, Herlon Saraiva Martins, Sabrina Correa Costa Ribeiro, Li Y Ho, Murilo Chiamolera, Marcelo M C Magri, Augusto Scalabrini-Neto, and Irineu Tadeu Velasco.
• Emergency Department, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
• Eur J Emerg Med. 2012 Jun 1;19(3):200-2.

AbstractDespite 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.

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