Clinical Risk Calculator of Khalil et al for a Patient with Fulminant Clostridium difficile Colitis

Description

Khalil et al reported a model for evaluating a patient with fulminant Clostridium difficile colitis who have undergone a colectomy. This can help to identify a patient who may require more aggressive management. The authors are from Sir Mortimer B. Davis Jewish General Hospital, McGill University and Centre Hospitalier Universitaire de Sherbrooke in Quebec.

Patient selection: status post colectomy for fulminant Clostridium difficile

Parameters:

(1) preoperative mechanical ventilation

(2) preoperative shock

(3) immunosuppression

(4) thrombocytopenia (platelet count < 150 * 10^9/L)

(5) preoperative WBC count in 10^9/L

(6) preoperative serum creatinine in mg/dL

(7) age in years

Parameter	Finding	Points
mechanical ventilation	no	0
	yes	0.47
preoperative shock	no	0
	yes	0.66
immunosuppression	no	0
	yes	0.47
thrombocytopenia	no	-0.98
	yes	0
preoperative WBC count	>= 50 * 10^9/L	3.41
	20 to 49.9	0.34
	4 to 19.9	0.44
	< 4 * 10^9/L	0
serum creatinine		(0.72 * (creatinine)) - (0.11 * ((creatinine)^2))
age		(0.001 * ((age) ^2)) - (0.11 * (age))

X =

= SUM(points for all of the parameters) + 0.45

probability of mortality =

= 1 / (1 + EXP((-1) * X))

Performance:

• The area under the ROC curve was 0.74 in the external validation cohort.

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Clinical Risk Calculator of Khalil et al for a Patient with Fulminant Clostridium difficile Colitis

Description

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