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Description

MacLeod et al reported nomograms for evaluate a patient with necrotizing fasciitis secondary to injection drug abuse. One nomogram predicts hospital survival. The authors are from the University of Dundee in Scotland and Ain Shams University in Cairo.


Patient selection: necrotizing fasciitis in a patient who injects drugs

 

Parameters:

(1) age in years, from 20 to 65 years

(2) blood lactate in mmol/L

(3) serum creatinine in µmol/L

(4) serum CRP in mg/L

(5) serum albumin in g/L, from 0 to 45

(6) blood glucose in mmol/L

 

Parameter

Points

age in years

78.144 - (1.202 * (age))

blood lactate

47 - (5.222 * (lactate))

serum CRP

100 - (0.1818 * (CRP))

serum albumin

0.6067 * (albumin)

blood glucose

71.831 - (2.565 * (glucose))

 

where:

• Table 7 gives glucose in mg/L but the values are more consistent with mmol/L.

 

Serum Creatinine

Points

20 to 60 µmmol/L

(1.294 * (creatinine)) + 18.93

60 to 80 µmol/L

(0.13 * (creatinine)) + 88.3

80 to 280 µmol/L

138.18 - (0.4935 * (creatinine))

 

total score =

= SUM(points for all of the parameters

 

Interpretation:

• minimum score: 0

• maximum score: 393.8

 

linear predictor =

= (0.03548 * (score)) - 10.79

 

probability of hospital survival =

= 1 / (1 + EXP((-1) * X))

 

Performance:

• The area under the ROC curve is 0.70.


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