Kassam et al reported the CARDS score for predicting mortality for a hospitalized adult with Clostridium difficile disease. This can help to identify a patient who may benefit from more aggressive management. The authros are from Massachusetts Institute of Technology, OpenBiome, Harvard University, University of Calgary, the University of Toronto and Massachusetts General Hospital.
The name is derived from critical care (C), age (A), renal failure (R), diabetes (D) and serious comorbidities (S).
Patient selection: hospitalized adult with Clostridium difficile disease, 18 to 100 years
Outcome: mortality
Parameters:
(1) ICU admission (critical care)
(1) age in years
(2) acute renal failure
(3) diabetes
(4) serious cardiopulmonary disease
(5) serious liver disease
(6) inflammatory bowel disease (IBD)
(7) malignancy
|
Parameter |
Finding |
Points |
|
ICU admission |
no |
0 |
|
|
yes |
5 |
|
age in years |
18 to 40 years |
0 |
|
|
41 to 60 years |
2 |
|
|
61 to 80 years |
3 |
|
|
81 to 100 years |
4 |
|
acute renal failure |
no |
0 |
|
|
yes |
3 |
|
Diabetes |
no |
0 |
|
|
yes |
-1 |
|
cardiopulmonary disease |
absent |
0 |
|
|
present |
1 |
|
liver disease |
absent |
0 |
|
|
present |
2 |
|
inflammatory bowel disease |
absent |
0 |
|
|
present |
2 |
|
malignancy |
absent |
0 |
|
|
present |
2 |
total score =
= SUM(points for the 7 parameters)
Interpretation:
• minimum score: -1
• maximum score: 19
• The higher score the greater the mortality.
|
Score |
Mortality |
|
-1 |
< 1% |
|
0 to 10 |
(0.245 * ((score)^2)) - (0.465 * (score)) + 0.925 |
|
10 to 18 |
(0.6377 * ((score)^2)) - (7.731 * (score)) + 28.93 |
|
19 |
100% |
Performance:
• The area under the ROC curve was 0.77.
Specialty: Infectious Diseases, Gastroenterology
