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Description

Jacob et al reported a score for predicting complications in a patient with pyelonephritis. Renal imaging is indicated in a patient at high risk for complications. The authors are from Christian Medical College in Vellore.


Parameters:

(1) flank pain

(2) percent neutrophils in the differential count of the peripheral blood

(3) blood urea in mmol/L

(4) urine leukocyte count per high powered field (hpf)

 

Parameter

Finding

Points

flank pain

no

0

 

yes

3

percent neutrophils

<= 75%

0

 

> 75%

10

blood urea

<= 13.3 mmol/L

0

 

> 13.3 mmol/L

3

urine leukocyte count

<= 1,000 per hpf

0

 

> 1,000 per hpf

3

 

total screo =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 19

• The higher the score the greater the risk of complications.

• A score >= 12 had a sensitivity was 0.78 and specificity 0.67.

• A positive score requires the percent neutrophils and at least one of the other 3 findings.

 

Performance:

• The area under the ROC curve is 0.77.


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