Miller et al reported a simple clinical score for evaluating a patient with Clostridium difficile disease. This correlates with response to therapy. The authors are from Jewish General Hospital in Montreal.
Patient selection: Clostridium difficile
Parameters:
(1) age in years (A)
(2) treatment with systemic antibiotics >= 1 day during therapy for Clostridium difficile (T)
(3) leukocyte count per µL (L)
(4) serum albumin in g/L (A)
(5) serum creatinine in µmol/L (S)
|
Parameter |
Finding |
Points |
|
age |
< 60 years |
0 |
|
|
60 to 79 years |
1 |
|
|
>= 80 years |
2 |
|
systemic antibiotics |
No |
0 |
|
|
Yes |
2 |
|
leukocyte count |
< 16,000 per µL |
0 |
|
|
16,000 to 25,000 per µL |
1 |
|
|
> 25,000 per µL |
2 |
|
serum albumin |
> 35 g/L |
0 |
|
|
26 to 35 g/L |
1 |
|
|
< 26 g/L |
2 |
|
serum creatinine |
<= 120 µmol/L |
0 |
|
|
121 to 179 µmol/L |
1 |
|
|
>= 180 µmol/L |
2 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The lower the score the better the cure rate during therapy.
• A score >= 8 is associated with increased mortality.
cure rate in percent =
= 100 - (5.08 * (ATLAS score))
Performance:
• The area under the ROC curve was 0.71.
Purpose: To evaluate a patient with Clostridium difficile disease using the ATLAS score of Miller et al.
Specialty: Infectious Diseases, Gastroenterology
Objective: other testing, criteria for diagnosis, response to therapy
ICD-10: A04.7, A41.4, A48.0, B96.8,
