A number of intensive care scoring systems have demonstrated their power in using physiological derangement to predict mortality or higher resource requirements, whatever the presenting diagnosis [45] [46] [47] [48] [49] . Physiological scores have also been demonstrated to be good predictors of requirement for higher level care on hospital wards [50] , in medical assessment units [51, 52] and in the Emergency Department [53] . We have demonstrated that a purely clinical score incorporating acute physiological derangement and chronic health and performance status can reliably predict requirement for critical care [54] .