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 |
Specialty: Infectious Diseases