Bewick et al developed a simple score for deciding whether a patient has influenza-related pneumonia or a community-acquired pneumonia (CAP). The authors are from the Influenza Clinical Information Network (FLU-CIN).
Patient selection: adult with pneumonia during H1N1 pandemic
Parameters from multivariate analysis:
(1) age in years
(2) temperature in °C
(3) mental orientation
(4) white blood cell count
(5) bilateral consolidation on chest X-ray
|
Parameter |
Finding |
Points |
|
age of the patient in years |
> 65 years of age |
0 |
|
|
<= 65 years of age |
1 |
|
temperature in °C |
< 38°C |
0 |
|
|
>= 38°C |
1 |
|
mental orientation |
disoriented |
0 |
|
|
oriented to person, time and place |
1 |
|
white blood cell count |
> 12,000 per µL |
0 |
|
|
<= 12,000 per µL |
1 |
|
bilateral consolidation on chest X-ray |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
|
Total Score |
H1N1 Pneumonia |
|
0 or 1 |
unlikely |
|
2 or 3 |
indeterminate |
|
4 or 5 |
likely |
Performance:
• A score of 4 or 5 had a positive likelihood ratio of 9.
• A score of 0 or 1 had a negative likelihood ratio of 76.
Specialty: Infectious Diseases, Pedatrics
