Thabane et al developed a risk score for predicting the risk of irritable bowel syndrome (IBS) developing after an episode of acute gastroenteritis. The authors are from McMaster University in Hamilton, Ontario.
Patient selection: acute gastroenteritis and age >= 16 years
Parameters:
(1) age
(2) gender
(3) duration of diarrhea in days
(4) maximum number of stools per day
(5) bloody stools
(6) abdominal cramps
(7) fever
(8) weight loss
(9) anxiety and/or depression (including post-traumatic stress disorder)
|
Parameter |
Finding |
Points |
|
age |
< 60 years |
6 |
|
|
>= 60 years |
0 |
|
gender |
male |
0 |
|
|
female |
9 |
|
duration of diarrhea |
<= 7 days |
0 |
|
|
> 7 days |
7 |
|
maximum number of stools per day |
<= 6 |
0 |
|
|
> 6 |
8 |
|
bloody stools |
no |
0 |
|
|
yes |
4 |
|
abdominal cramps |
no |
0 |
|
|
yes |
32 |
|
fever |
no |
0 |
|
|
yes |
5 |
|
weight loss |
none or <= 10 lbs |
0 |
|
|
> 10 lbs |
8 |
|
anxiety and/or depression |
none |
0 |
|
|
premorbid |
1 |
|
|
post-infection |
10 |
|
|
both |
11 |
where:
• The paper says that the maximum score is 90. The only way to achieve this is to score both premorbid and post-infectious anxiety and depression.
• Age in Table 4 is given as < 60 and > 60. Table 2 indicates < 60 is the risk factor.
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 90
• The higher the score the greater the risk of IBS.
The risk can be estimated by the equation:
percent IBS =
= (0.01047 * ((score)^2)) + (0.0267 * (score)) + 0.559
Performance:
• The area under the ROC curve was 0.7.
• The sensitivity was 25-35% with specificity 90%.
• The positive predictive value ranged from 53 to 64%. The negative predictive value was 72%.
Purpose: To identify a patient at risk for irritable bowel syndrome following acute gastroenteritis based on the score of Thabane et al.
Specialty: Gastroenterology
Objective: risk factors, severity, prognosis, stage
ICD-10: A02.0, A08, A09, J10.8, J11.8, K52, K58,
