Patient selection: suppurative kidney infection (abscess, pyelonephritis, etc)
Parameters:
(1) sepsis syndrome
(2) early antibiotic therapy (adequate if isolates susceptible to at least 1 antibiotic)
(3) adequate complete urologic procedure (complete drainage, source control, nephrectomy, all purulent collections drained)
|
Parameter
|
Finding
|
OR
|
Points
|
|
sepsis syndrome
|
no
|
1
|
0
|
|
|
yes
|
19.3
|
5
|
|
early antibiotic therapy
|
adequate
|
1
|
0
|
|
|
inadequate
|
7.7
|
4
|
|
complete urologic procedure
|
early
|
0.012
|
0
|
|
|
late, not done or incomplete
|
1
|
13
|
where:
• In the original table early complete urologic procedure is shown as +13. However, the odds ratio is 0.012 indicating a negative impact. This indicates that an early adequate urologic procedure should be assigned –13 if late therapy was scored 0.
• The point value can be generated by dividing the boostrap beta coefficients (0.25, 0.19, 0.644 respectively) by 0.05.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 22
• A score > 5 identifies patients with early treatment failure.
Performance:
• A score > 5 identified 91-93% of patients who failed in the various study groups.
