Predictive Model of Diagnosing Probable Cases of Severe Acute Respiratory Syndrome in Febrile Patients with Exposure Risk

Shey Ying Chen, Chan Ping Su, Matthew Huei Ming Ma, Wen Chu Chiang, Chiung Yuan Hsu, Patrick Chow In Ko, Kuang Chau Tsai, Zui Shen Yen, Fuh Yuan Shih, Shyr Chyr Chen, Wen Jone Chen

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Study objective: Since the World Health Organization issued a global alert about severe acute respiratory syndrome (SARS) on March 12, 2003, the illness has become a major public health challenge worldwide. The objective of this study is to identify the clinical risk factors of SARS and to develop a scoring system for early diagnosis. Methods: The detailed clinical data of all patients presenting to the emergency department (ED) with a temperature higher than 38.0°C (100.3°F), documented at home or at the ED, and risks of exposure to SARS within 14 days were assessed. The diagnosis of probable SARS was made according to the definition of the Centers for Disease Control and Prevention. Items with significant differences among symptoms, signs, and laboratory tests on presentation between SARS and non-SARS groups were determined and used to develop the scoring system. Results: Seventy patients were enrolled and 8 were diagnosed as probably having SARS. None of the initially discharged patients or their relatives developed SARS. Compared with the non-SARS group, the SARS group was younger (33.9±15.9 years versus 44±9.8 years; P=.02), had a higher percentage of fever prolonged more than 5 days (87.5% versus 6.5%; P<.01), myalgia (75% versus 27.4%; P=.01), and diarrhea (50% versus 9.7%; P=.02); had less occurrence of cough before or during fever (0% versus 64.5%; P=.01); and had lower absolute lymphocyte (0.9±0.3×109/L versus 1.5±1.1×10 9/L; P<.01) and platelet counts (144.1±36.3×10 9/L versus 211.6±78.8×109/L; P=.02). A 4-item symptom score based on the presence of cough before or concomitant with fever, myalgia, diarrhea, and rhinorrhea or sore throat detects SARS with 100% sensitivity and 75.9% specificity; a 6-item clinical score based on lymphopenia (<1.0×109/L), thrombocytopenia (<150×10 9/L) and the 4 symptom items detects SARS with 100% sensitivity and 86.3% specificity. Conclusion: Certain symptoms and laboratory tests indicate higher risk of febrile probable SARS. In nonendemic areas, the febrile patients with recent contact with SARS or travel history to endemic areas could be screened for the probability of SARS by the use of clinical and symptom scores.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalAnnals of Emergency Medicine
Volume43
Issue number1
DOIs
Publication statusPublished - Jan 1 2004
Externally publishedYes

Fingerprint

Severe Acute Respiratory Syndrome
Fever
Myalgia
Cough
Hospital Emergency Service
Diarrhea
Sensitivity and Specificity
Lymphopenia
Pharyngitis
Centers for Disease Control and Prevention (U.S.)
Platelet Count
Thrombocytopenia
Signs and Symptoms
Early Diagnosis

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Predictive Model of Diagnosing Probable Cases of Severe Acute Respiratory Syndrome in Febrile Patients with Exposure Risk. / Chen, Shey Ying; Su, Chan Ping; Ma, Matthew Huei Ming; Chiang, Wen Chu; Hsu, Chiung Yuan; Ko, Patrick Chow In; Tsai, Kuang Chau; Yen, Zui Shen; Shih, Fuh Yuan; Chen, Shyr Chyr; Chen, Wen Jone.

In: Annals of Emergency Medicine, Vol. 43, No. 1, 01.01.2004, p. 1-5.

Research output: Contribution to journalArticle

Chen, SY, Su, CP, Ma, MHM, Chiang, WC, Hsu, CY, Ko, PCI, Tsai, KC, Yen, ZS, Shih, FY, Chen, SC & Chen, WJ 2004, 'Predictive Model of Diagnosing Probable Cases of Severe Acute Respiratory Syndrome in Febrile Patients with Exposure Risk', Annals of Emergency Medicine, vol. 43, no. 1, pp. 1-5. https://doi.org/10.1016/S0196-0644(03)00817-5
Chen, Shey Ying ; Su, Chan Ping ; Ma, Matthew Huei Ming ; Chiang, Wen Chu ; Hsu, Chiung Yuan ; Ko, Patrick Chow In ; Tsai, Kuang Chau ; Yen, Zui Shen ; Shih, Fuh Yuan ; Chen, Shyr Chyr ; Chen, Wen Jone. / Predictive Model of Diagnosing Probable Cases of Severe Acute Respiratory Syndrome in Febrile Patients with Exposure Risk. In: Annals of Emergency Medicine. 2004 ; Vol. 43, No. 1. pp. 1-5.
@article{c75578cb9e1141af8be297e6369dab1e,
title = "Predictive Model of Diagnosing Probable Cases of Severe Acute Respiratory Syndrome in Febrile Patients with Exposure Risk",
abstract = "Study objective: Since the World Health Organization issued a global alert about severe acute respiratory syndrome (SARS) on March 12, 2003, the illness has become a major public health challenge worldwide. The objective of this study is to identify the clinical risk factors of SARS and to develop a scoring system for early diagnosis. Methods: The detailed clinical data of all patients presenting to the emergency department (ED) with a temperature higher than 38.0°C (100.3°F), documented at home or at the ED, and risks of exposure to SARS within 14 days were assessed. The diagnosis of probable SARS was made according to the definition of the Centers for Disease Control and Prevention. Items with significant differences among symptoms, signs, and laboratory tests on presentation between SARS and non-SARS groups were determined and used to develop the scoring system. Results: Seventy patients were enrolled and 8 were diagnosed as probably having SARS. None of the initially discharged patients or their relatives developed SARS. Compared with the non-SARS group, the SARS group was younger (33.9±15.9 years versus 44±9.8 years; P=.02), had a higher percentage of fever prolonged more than 5 days (87.5{\%} versus 6.5{\%}; P<.01), myalgia (75{\%} versus 27.4{\%}; P=.01), and diarrhea (50{\%} versus 9.7{\%}; P=.02); had less occurrence of cough before or during fever (0{\%} versus 64.5{\%}; P=.01); and had lower absolute lymphocyte (0.9±0.3×109/L versus 1.5±1.1×10 9/L; P<.01) and platelet counts (144.1±36.3×10 9/L versus 211.6±78.8×109/L; P=.02). A 4-item symptom score based on the presence of cough before or concomitant with fever, myalgia, diarrhea, and rhinorrhea or sore throat detects SARS with 100{\%} sensitivity and 75.9{\%} specificity; a 6-item clinical score based on lymphopenia (<1.0×109/L), thrombocytopenia (<150×10 9/L) and the 4 symptom items detects SARS with 100{\%} sensitivity and 86.3{\%} specificity. Conclusion: Certain symptoms and laboratory tests indicate higher risk of febrile probable SARS. In nonendemic areas, the febrile patients with recent contact with SARS or travel history to endemic areas could be screened for the probability of SARS by the use of clinical and symptom scores.",
author = "Chen, {Shey Ying} and Su, {Chan Ping} and Ma, {Matthew Huei Ming} and Chiang, {Wen Chu} and Hsu, {Chiung Yuan} and Ko, {Patrick Chow In} and Tsai, {Kuang Chau} and Yen, {Zui Shen} and Shih, {Fuh Yuan} and Chen, {Shyr Chyr} and Chen, {Wen Jone}",
year = "2004",
month = "1",
day = "1",
doi = "10.1016/S0196-0644(03)00817-5",
language = "English",
volume = "43",
pages = "1--5",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Predictive Model of Diagnosing Probable Cases of Severe Acute Respiratory Syndrome in Febrile Patients with Exposure Risk

AU - Chen, Shey Ying

AU - Su, Chan Ping

AU - Ma, Matthew Huei Ming

AU - Chiang, Wen Chu

AU - Hsu, Chiung Yuan

AU - Ko, Patrick Chow In

AU - Tsai, Kuang Chau

AU - Yen, Zui Shen

AU - Shih, Fuh Yuan

AU - Chen, Shyr Chyr

AU - Chen, Wen Jone

PY - 2004/1/1

Y1 - 2004/1/1

N2 - Study objective: Since the World Health Organization issued a global alert about severe acute respiratory syndrome (SARS) on March 12, 2003, the illness has become a major public health challenge worldwide. The objective of this study is to identify the clinical risk factors of SARS and to develop a scoring system for early diagnosis. Methods: The detailed clinical data of all patients presenting to the emergency department (ED) with a temperature higher than 38.0°C (100.3°F), documented at home or at the ED, and risks of exposure to SARS within 14 days were assessed. The diagnosis of probable SARS was made according to the definition of the Centers for Disease Control and Prevention. Items with significant differences among symptoms, signs, and laboratory tests on presentation between SARS and non-SARS groups were determined and used to develop the scoring system. Results: Seventy patients were enrolled and 8 were diagnosed as probably having SARS. None of the initially discharged patients or their relatives developed SARS. Compared with the non-SARS group, the SARS group was younger (33.9±15.9 years versus 44±9.8 years; P=.02), had a higher percentage of fever prolonged more than 5 days (87.5% versus 6.5%; P<.01), myalgia (75% versus 27.4%; P=.01), and diarrhea (50% versus 9.7%; P=.02); had less occurrence of cough before or during fever (0% versus 64.5%; P=.01); and had lower absolute lymphocyte (0.9±0.3×109/L versus 1.5±1.1×10 9/L; P<.01) and platelet counts (144.1±36.3×10 9/L versus 211.6±78.8×109/L; P=.02). A 4-item symptom score based on the presence of cough before or concomitant with fever, myalgia, diarrhea, and rhinorrhea or sore throat detects SARS with 100% sensitivity and 75.9% specificity; a 6-item clinical score based on lymphopenia (<1.0×109/L), thrombocytopenia (<150×10 9/L) and the 4 symptom items detects SARS with 100% sensitivity and 86.3% specificity. Conclusion: Certain symptoms and laboratory tests indicate higher risk of febrile probable SARS. In nonendemic areas, the febrile patients with recent contact with SARS or travel history to endemic areas could be screened for the probability of SARS by the use of clinical and symptom scores.

AB - Study objective: Since the World Health Organization issued a global alert about severe acute respiratory syndrome (SARS) on March 12, 2003, the illness has become a major public health challenge worldwide. The objective of this study is to identify the clinical risk factors of SARS and to develop a scoring system for early diagnosis. Methods: The detailed clinical data of all patients presenting to the emergency department (ED) with a temperature higher than 38.0°C (100.3°F), documented at home or at the ED, and risks of exposure to SARS within 14 days were assessed. The diagnosis of probable SARS was made according to the definition of the Centers for Disease Control and Prevention. Items with significant differences among symptoms, signs, and laboratory tests on presentation between SARS and non-SARS groups were determined and used to develop the scoring system. Results: Seventy patients were enrolled and 8 were diagnosed as probably having SARS. None of the initially discharged patients or their relatives developed SARS. Compared with the non-SARS group, the SARS group was younger (33.9±15.9 years versus 44±9.8 years; P=.02), had a higher percentage of fever prolonged more than 5 days (87.5% versus 6.5%; P<.01), myalgia (75% versus 27.4%; P=.01), and diarrhea (50% versus 9.7%; P=.02); had less occurrence of cough before or during fever (0% versus 64.5%; P=.01); and had lower absolute lymphocyte (0.9±0.3×109/L versus 1.5±1.1×10 9/L; P<.01) and platelet counts (144.1±36.3×10 9/L versus 211.6±78.8×109/L; P=.02). A 4-item symptom score based on the presence of cough before or concomitant with fever, myalgia, diarrhea, and rhinorrhea or sore throat detects SARS with 100% sensitivity and 75.9% specificity; a 6-item clinical score based on lymphopenia (<1.0×109/L), thrombocytopenia (<150×10 9/L) and the 4 symptom items detects SARS with 100% sensitivity and 86.3% specificity. Conclusion: Certain symptoms and laboratory tests indicate higher risk of febrile probable SARS. In nonendemic areas, the febrile patients with recent contact with SARS or travel history to endemic areas could be screened for the probability of SARS by the use of clinical and symptom scores.

UR - http://www.scopus.com/inward/record.url?scp=9144223669&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9144223669&partnerID=8YFLogxK

U2 - 10.1016/S0196-0644(03)00817-5

DO - 10.1016/S0196-0644(03)00817-5

M3 - Article

VL - 43

SP - 1

EP - 5

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 1

ER -