medical decision support medical decision support
Sign In

Model of Wall et al for Identifying Patients with Necrotizing Fasciitis

Description

Some patients with necrotizing fasciitis may present with relatively mild clinical findings, and these patients may not undergo debridement until the disease has progressed to a severe stage of involvement. Wall et al developed a simple model for separating patients with necrotizing fasciitis from those with nonnecrotizing soft tissue infections. The authors are from the Harbor-UCLA Medical Center in Torrance, California.


 

Data:

(1) admission white blood cell (WBC) count

(2) serum sodium, corrected if the glucose was elevated.

 

If the serum glucose is > 200 mg/dL:

 

corrected sodium level in mmol/L =

= (measured sodium in mmol/L) + (0.016 * ((measured glucose in mg/dL) – 100))

 

The model was considered positive if EITHER:

(1) admission WBC > 15,400 per µL

(2) corrected serum sodium was < 135 mEq/L

 

Performance:

• 90% of necrotizing fasciitis and 24% of nonnecrotizing fasciitis patients were considered positive, give a sensitivity of 90% and a specificity of 76%.

• The positive predictive value was 26% and the negative predictive value was 99%

• 61% of patients with necrotizing fasciitis did not have definite clinical signs of necrotizing fasciitis when admitted. 95% of these patients were considered positive by the model.

 


To read more or access our algorithms and calculators, please log in or register.

Specialty

ICD-10