Clinical Decision Rule of Wang et al for Severe Acute Respiratory Syndrome (SARS)

Description

Wang et al developed a score for the diagnosis of severe acute respiratory syndrome (SARS) in the Emergency Department. This can help to identify patients quickly. The authors are from Taipei Medical University and Shin-Kong Wu Ho-Su Memorial Hospital in Taiwan.

Patient selection: severe respiratory symptoms in the Emergency Department

Parameters at presentation:

(1) chest X-ray findings

(2) sputum inflammation

(3) lymphocytopenia

(4) history of exposure

(5) serum LDH in U/L

(6) C-reactive protein (CRP) in mg/dL

(7) activated partial thromboplastin time (aPTT) in seconds

Parameter	Finding	Points
chest X-ray	multilobar or bilateral infiltrates	3
	other	0
sputum inflammation	monocyte predominate	3
	other	0
lymphocytopenia	absent	0
	present	2
history of exposure	no	0
	yes	1
serum LDH	<= 450 U/L	0
	> 450 U/L	1
CRP	<= 5.0 mg/dL	0
	> 5.0 mg/dL	1
aPTT	<= 40 seconds	0
	> 40 seconds	1

total score =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 12

• A score >= 6 had sensitivity of 100% and specificity of 93%. The negative predictive value was 100%.

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Clinical Decision Rule of Wang et al for Severe Acute Respiratory Syndrome (SARS)

Description

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