Fukui et al reported a clinical decision rule for identifying a patient with pyelonephritis who has bacteremia. The authors are from Juntendo University and St. Luke's International Hospital.
Patient selection: pyelonephritis
Parameters:
(1) white blood cell count per microliter
(2) chills
(3) serum albumin in g/dL
(4) serum AST in IU/L
WBC Count
Chills
Albumin
AST
Risk Bacteremia
> 21,000
NA
NA
NA
very high (90%)
<= 21,000
no
> 3.6
NA
low (16%)
<= 21,000
no
<= 3.6
NA
moderate (45%)
<= 21,000
yes
NA
> 19
high (69%)
<= 21,000
yes
NA
<= 19
moderate (35%)
Performance:
• The area under the ROC curve was 0.75.
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