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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