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Description

Leung et al developed a clinical prediction rule for diagnosing the Severe Acute Respiratory Syndrome (SARS) in the Emergency Department. This involves 2 scores - Step 1 and Step 2. The authors are from multiple hospitals in Hong Kong and the Hospital Authority SARS Collaborative Group.


 

Patient selection: patient coming to the ED with respiratory complaints during SARS outbreak

 

Parameters:

(1) age in years

(2) contact history

(3) fever on presentation (tympanic temperature >= 38°C)

(4) myalgia on presentation

(5) malaise on presentation

(6) sputum on presentation

(7) abdominal pain on presentation

(8) sore throat on presentation

(9) rhinorrhea on presentation

 

Parameter

Finding

Points

age in years

< 18 years

-1

 

18 to 64 years of age

0

 

>= 65 years of age

-5

contact history

no

0

 

yes

8

fever on presentation

no

0

 

yes

15

myalgia on presentation

no

0

 

yes

3

malaise on presentation

no

0

 

yes

3

sputum on presentation

no

0

 

yes

-4

abdominal pain on presentation

no

0

 

yes

-8

sore throat on presentation

no

0

 

yes

-5

rhinorrhea on presentation

no

0

 

yes

-4

 

total score for step 1 =

= SUM(points for all 9 parameters)

 

Interpretation:

• minimum score: -27

• maximum score: +29

• A score >= -3 indicates a high-risk group.

• A score < -3 indicates a low-risk group.

 

Performance:

• The Step 1 score has a sensitivity of 99%.


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