The prognosis of lower respiratory tract infections (LRTI) can be estimated with the help of a prediction rule; patients with a low score have much less chance of a complicated course compared to patients with a high score. Most of the present prediction rules are developed for patients seen in hospital.

Jettie Bont (Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands) and her colleagues have conceived a prediction rule for elderly patients with acute LRTI in the community, to estimate the risk of 30-day hospitalisation or death. The prediction rule includes the following items, which all represent a certain score: increasing age, previous hospitalisation, heart failure, diabetes, use of oral glucocorticoids, previous use of antibiotics and a diagnosis of pneumonia or exacerbation of chronic obstructive pulmonary disease (COPD). Patients with a low score have a risk of less than 3% to be hospitalised or die within the next 30 days, compared to more than 30% if the score is high.

This simple prediction rule can help the primary care physician to differentiate between high- and low-risk patients. As a possible consequence, low-risk patients may be suitable for home treatment whereas high risk patients might be monitored more closely in a homecare or hospital setting.

"A prediction rule for elderly primary-care patients with lower respiratory tract infections"
European Respiratory Journal (ERJ)