Description

Artenstein et al reported a model for the early diagnosis of a spinal epidural abscess in an adult. This can help to identify a patient who should have emergency spinal imaging. The authors are from Baystate Health and the University of Massachusetts.


Patient selection: adult

 

Parameters:

(1) fever and/or rigor

(2) antimicrobial use in the past 30 days

(3) back and/or neck pain

(4) injection drug use

(5) age in years

 

Parameter

Finding

Points

fever and/or rigor

no

0

 

yes

2

antimicrobial use

no

0

 

yes

2

back and/or neck pain

no

0

 

yes

2

injection drug use

no

0

 

yes

2

age in years

20 to 29 years

0

 

30 to 49 years

3

 

50 to 59 years

4

 

60 to 69 years

2

 

70 to 79 years

4

 

>= 80 years

3

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 12

• A score >= 5 has a sensitivity of 96% and specificity of 34%

• A score >= 6 has a sensitivity of 89% and specificity of 63%.

 

Performance:

• The area under the ROC curve is 0.88.


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