Physiological-social scoring is important in pandemic flu

doi:10.1136/bmj.332.7542.669

BMJ 2006;332:669 (18 March), doi:10.1136/bmj.332.7542.669

Letter

Physiological-social scoring is important in pandemic flu

The first 150 words of the full text of this article appear below.

EDITOR—Barlow argues that prognostic assessment will beimportant in a flu pandemic.¹ Although the predictive toolsCURB-65 and CRB-65 have been validated in terms of 30 day mortality,²their limitations with respect to prediction of mortality haverecently been highlighted. Their value as a track and triagetool has not been established.

This is of prime importance as the numbers of presentationsexpected during a flu pandemic require that an instrument bedeveloped which recognises the physiological derangement andsocial and comorbid factors which normally influence hospitaladmission criteria. Ideally, this tool would be applicable acrossthe health economy and amenable to use in primary and secondarycare by medical, nursing, and allied health professionals.

Given the magnitude of a pandemic (we calculate that attendancesat our emergency department may be in excess of 600% of normal³),it is imperative that any clinical guidance recognises thatdegradation . . . [Full text of this article]

Kirsty Challen, research fellow in emergency medicine

kirsty.challen@smtr.nhs.uk South Manchester University Hospitals Trust, Manchester M23 9LT

John Bright, specialist registrar in respiratory medicine, Andrew Bentley, consultant in respiratory medicine and critical care, Darren Walter, clinical director, emergency medicine

South Manchester University Hospitals Trust, Manchester M23 9LT