Arnold et al developed a prediction rule for identifying a pediatric patient who needs to be admitted to the hospital for an asthma exacerbation. The authors are from Vanderbilt University.
Patient selection: pediatric patient from 5 to 18 years of age with asthma
Outcome: hospital admission
Parameters:
(1) age in years
(2) gender (sex)
(3) need for reliever/rescue therapy more than 2 times per week
(4) expiratory phase prolongation
(5) oxygen saturation in percent from 100 to 82
points for age from 5 to 10 =
= (1.42 * (age)) - 7.1
points for age from 10 to 18 =
= (3.38 * (age)) - 27.2
points for oxygen saturation =
= 555.5556 - (5.5556 * (saturation))
Parameter
Finding
Points
gender (sex)
male
0
female
8.3
need for reliever or rescue
no
0
yes
5.8
expiratory phase prolongation
1:1
0
1:2
2.5
1:3 or more
32.3
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 180.4
• The higher the score the greater the risk of hospitalization.
Score
Percent Hospitalized
< 17.3
< 5%
17.3 to 146
X = (0.04567 * (score)) - 3.79
probability = 1 / (1+EXP((-1) * X))
> 146
> 95%
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