Oza et al reported risk scores for the triage of patients for Ebola. One score is based on symptoms alone and a second is based on both symptoms and laboratory findings. The authors are from Save the Children International and the London School of Hygiene and Tropical Medicine.
Patient selection: possible Ebola
Parameters:
(1) conjunctivitis
(2) diarrhea
(3) nausea and/or vomiting
(4) headache
(5) difficulty breathing
(6) loss of appetite
(7) serum ALT in U/L
(8) serum creatine kinase (CK) in U/L
(9) serum creatinine in µmol/L
(10) serum total bilirubin in µmol/L
|
Parameter
|
Finding
|
Points
|
|
conjunctivitis
|
no
|
0
|
|
|
yes
|
2
|
|
diarrhea
|
no
|
0
|
|
|
yes
|
2
|
|
nausea/vomiting
|
no
|
0
|
|
|
yes
|
1
|
|
headache
|
no
|
0
|
|
|
yes
|
-1
|
|
difficulty breathing
|
no
|
0
|
|
|
yes
|
-1
|
|
loss of appetite
|
no
|
0
|
|
|
yes
|
-1
|
|
serum ALT
|
<= 48 U/L
|
0
|
|
|
> 48 U/L
|
2
|
|
serum CK
|
<= 380 U/L
|
0
|
|
|
> 380 U/L
|
2
|
|
serum creatinine
|
<= 106 µmol/L
|
0
|
|
|
> 106 µmol/L
|
-1
|
|
serum total bilirubin
|
<= 27 µmol/L
|
0
|
|
|
> 27 µmol/L
|
-1
|
total symptom score = ESR =
= SUM(points for the 6 symptoms)
total symptom and laboratory score = ESLR =
= SUM(points for all 10 parameters)
Interpretation:
• minimum symptom score: -3
• maximum symptom score: 5
• minimum total score: -5 (reported as -4 in Table 4)
• maximum total score: 9
|
ESR or ESLR Score
|
Risk of Ebola
|
|
< 0
|
low
|
|
0
|
medium
|
|
> 0
|
high
|
Performance:
• The area under the ROC curve for the symptoms score (ESR) is 0.84.
• The area under the ROC curve for the symptom and laboratory score (ESLR) is 0.91.
