For initial risk assessment, patient-related risk factors that predict a severe course include the following: Age ≥ 60 years Comorbid health problems Obesity with body mass index > 30 Long-term, heavy alcohol use Presence of systemic inflammatory response syndrome (SIRS) Laboratory markers of hypovolemia (eg, elevated BUN, elevated hematocrit) Presence of pleural effusions and / or infiltrates on admission chest x-ray Altered mental status Severity scoring systems require multiple measurements and may delay appropriate management.