Patient selection: pediatric patient presenting to the Emergency Department, <= 18 years of age
Parameter:
(1) age in years
(2) race
(3) total parenteral nutrition (TPN)
(4) tunneled CVC
(5) double lumen central line
(6) other bacterial infection
(7) viral upper respiratory infection symptoms
(8) diarrhea
(9) temperature in °C in the Emergency Department
(10) fever prior to presentation
(11) absolute neutrophil count per microliter
(12) season of the year
|
Parameter
|
Finding
|
Points
|
|
age in yars
|
<= 5
|
1
|
|
|
> 5
|
0
|
|
race
|
Black
|
2
|
|
|
other
|
0
|
|
TPN
|
no
|
0
|
|
|
yes
|
3
|
|
tunneled catheter
|
no
|
0
|
|
|
yes
|
4
|
|
double lumen catheter
|
no
|
0
|
|
|
yes
|
2
|
|
other bacterial infection
|
no
|
2
|
|
|
yes
|
0
|
|
viral upper respiratory
|
no
|
2
|
|
|
yes
|
0
|
|
diarrhea
|
no
|
0
|
|
|
yes
|
2
|
|
temperature
|
< 39.5°C
|
0
|
|
|
>= 39.5°C
|
2
|
|
fever prior to presentation
|
no
|
0
|
|
|
yes
|
2
|
|
absolute neutrophil count
|
>= 500 per µL
|
0
|
|
|
< 500 per µL
|
3
|
|
season
|
spring or summer
|
1
|
|
|
fall or winter
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 26
• A score < 6 had a negative predictive value of 99.2% for CLABSI.
• The higher the score the greater the risk for CLABSI.
• The maximum Youden index was seen with 8 and 9 (0.439).
Performance:
• The area under the ROC curve is 0.81.
