SADFUL Score of Chen et al for Predicting a Patient with Bacteremia in the Emergency Department

Description

Chen et al reported the SADFUL score for predicting bacteremia in a patient returning to the Emergency Department. This can improve detection of a significant infection. The authors are from National Taiwan University in Taipei.

Patient selection: adult (age >= 18 years) in the Emergency Department with unscheduled revisit

SADFUL is an acronym based on the first letter of the 6 parameters.

Parameters:

(1) segmented neutrophil percentage

(2) age in years

(3) diabetes mellitus

(4) fever (>= 38°C)

(5) upper respiratory symptoms (cough, rhinorrhea, sore throat)

(6) leukopenia (< 4,000 per µL)

Parameter	Finding	Points
segmented neutrophil	<= 85%	0
	> 85%	3
age in years	<= 55 years	0
	> 55 years	1
diabetes mellitus	no	0
	yes	1
fever	no	0
	yes	2
upper respiratory symptoms	no	0
	yes	-2
leukopenia	no	0
	yes	2

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: -2

• maximum score: 9

• A score >= 3 or >= 4 can be used to diagnose bacteremia (based on the Youden index).

Performance:

• The area under the ROC curve was 0.78 in the derivation and 0.79 in the validation cohorts.

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SADFUL Score of Chen et al for Predicting a Patient with Bacteremia in the Emergency Department

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