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From the authors

University Medical Center Utrecht, Utrecht, The Netherlands.

We would like to thank S. Teramoto and co-workers for the important issues they raised. While appraising their comments, it is important to make a distinction between the use of severity rules inside and outside hospital settings. Looking at the available literature, we think that the pneumonia severity index (PSI) and CURB-65 (Confusion, Urea >7 mmol·L^–1, Respiratory rate 30 breaths·min^–1, Blood pressure (systolic value <90 mmHg or diastolic value 60 mmHg)) are both valid and useful in hospital settings. However, it is an interesting suggestion to improve CURB-65 by introducing more detailed age groups in the score. In primary care, PSI and CURB-65 are less useful for various reasons. Regarding the predictive value of age, the results of our study 1 showed that age >80 yrs was a better predictor of outcome than age categories between 65–80 yrs. Probably as there are a lot of healthy individuals aged 65–80 yrs in primary care who have a low risk for poor outcome.

Statement of interest

None declared.

REFERENCES

1. Bont J, Hak E, Hoes AW, Schipper M, Schellevis FG, Verheij TJ. A prediction rule for elderly primary-care patients with lower respiratory tract infections. Eur Respir J 2007;29:969–975.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Verheij, T. Articles by Hoes, A. Search for Related Content PubMed Articles by Verheij, T. Articles by Hoes, A.