Krastev et al developed the Biliary Tract Infection Score (BTIS) to describe the clinical severity of an infection of the biliary tract. This can help identify patients who may require more aggressive management. The authors are from St. I. Rilski University Hospital and Tz. Joanna University Hospital in Sofia, Bulgaria.
Parameters:
(1) local symptoms (upper abdominal pain and tenderness, other)
(2) body temperature and fever
(3) erythrocyte sedimentation rate (ESR)
(4) white blood cell (WBC) count
(5) serum ALT
(6) serum AST
(7) serum conjugated bilirubin in µmol/L
(8) serum alkaline phosphatase
|
Parameter |
Finding |
Points |
|
local symptoms |
none |
0 |
|
|
mild |
1 |
|
|
severe |
2 |
|
body temperature |
normal |
0 |
|
|
<= 38°C |
1 |
|
|
> 38°C |
2 |
|
ESR |
normal |
0 |
|
|
<= 2 times upper limit of normal |
1 |
|
|
> 2 times ULN |
2 |
|
WBC count |
normal |
0 |
|
|
<= 2 times ULN |
1 |
|
|
> 2 times ULN |
2 |
|
serum ALT |
normal |
0 |
|
|
<= 3 times ULN |
1 |
|
|
> 3 times ULN |
2 |
|
serum AST |
normal |
0 |
|
|
<= 3 times ULN |
1 |
|
|
> 3 times ULN |
2 |
|
serum conjugated bilirubin |
normal |
0 |
|
|
<= 30 µmol/L |
1 |
|
|
> 30 µmol/L |
2 |
|
serum alkaline phosphatase |
normal |
0 |
|
|
<= 1.5 times ULN |
1 |
|
|
> 1.5 times ULN |
2 |
where:
• ULN = upper limit of normal
• The value for normal body temperature was not given. According to LeBlond at al the normal range is 36.0 - 37.5°C (96.5 - 99.5 °F).
• The data for the score (in Table 1, page 793) has values described as "<" and ">" but omits "=". I made the 1 point assignment for "<=".
total BTIS =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the more severe the infection.
• The BTIS can be measured before and after therapy. After successful therapy the BTIS should be significantly lower.
Specialty: Infectious Diseases, Gastroenterology
ICD-10: ,
