Neal et al reported a score for determining the severity of Clostridium difficile colitis. This can help to identify a patient early who may require surgery. The authors are from the University of Pittsburgh, University of Chicago and the VA Pittsburgh Healthcare System.
Patient selection: Clostridium difficile colitis
Parameters:
>=7>=7
Parameter
Finding
Points
immunosuppression and/or chronic medical condition
absent
0
present
1
abdominal pain or distention
no
0
yes
1
serum albumin
>= 3 g/dL
0
< 3 g/dL
1
body temperature
<= 38.5°C
0
> 38.5°C
1
ICU admission
no
0
yes
1
CT scan with nonspecific findings
no
0
yes
2
WBC count
< 1,500 per µL
2
> 15,000 per µL
2
bands > 10%
2
other
0
serum creatinine ratio
<= 1.5
0
> 1.5
2
abdominal peritoneal signs
no
0
yes
3
vasopressors required
no
0
yes
5
mechanical ventilation
no
0
yes
5
disorientation, confusion, altered LOC
no
0
yes
5
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 29
• The higher the score the greater the severity of the Clostridium difficile colitis.
Total Score
Severity C. diff Colitis
0
1 to 3
mild to moderate
4 to 6
severe
>= 7
severe, complicated
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