Predictors of Leung et al for a Diagnosis of Severe Acute Respiratory Syndrome (SARS) in the Emergency Department: Step 2

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) sputum on presentation

(5) chest radiograph

(6) absolute lymphocyte count per µL

(8) absolute neutrophil count per µL

(9) platelet count per µL

Parameter	Finding	Points
age in years	< 18 years	-1
	18 to 64 years of age	0
	>= 65 years of age	-6
contact history	no	0
	yes	7
fever on presentation	no	0
	yes	5
sputum on presentation	no	0
	yes	-4
chest radiograph	normal	0
	haziness	8
	pneumonia, unilateral lesion, bilateral lesion	8
absolute lymphocyte count	< 1,500 per µL	5
	1,500 to 4,000 per µL	0
	> 4,000 per µL	5
absolute neutrophil count	< 2,000 per µL	4
	2,000 to 7,500 per µL	0
	> 7,500 per µL	-5
platelet count	< 150,000 per µL	5
	150,000 to 400,000 per µL	0
	> 400,000 per µL	-5

total score for step 2 =

= SUM(points for all 9 parameters)

Interpretation:

• minimum score: -20

• maximum score: +34

• A score >= 8 indicates a high-risk group.

• A score < 8 indicates a low-risk group.

Performance:

• The Step 1 score has a sensitivity of 95%.

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Description

Specialty

ICD-10