Department of Infectious Disease and Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Eval Clin Pract. 2010 Dec;16(6):1248-53. doi: 10.1111/j.1365-2753.2009.01306.x. Epub 2010 Aug 15.
RATIONALE, AIMS AND OBJECTIVES: Acute fever is the most common clinical symptom for infectious diseases. It is necessary to identify risk factors for infectious patients with acute fever and formulate activation criteria of early warning infectiosity score system (EWIS) to alert outpatient clinic doctors.
Logistic regression analysis was used to determine risk factors for infectious diseases from the clinical data of 758 patients with acute fever. Risk factors were weighted and an EWIS was formulated. A receiver operator characteristic (ROC) analysis of weighted cumulative scores was performed to evaluate the diagnostic accuracy of EWIS, and the Kappa test used to confirm diagnostic reliability. A χ(2) -test for trend was applied to determine the relevance between EWIS and incidence of infectious diseases.
Risk factors for infections included conjunctival hyperaemia, rash, diarrhoea, increased alanine aminotransferase, splenomegaly and abnormal percentage of peripheral neutrophils (NE%). Risk factors were weighted and tabulated. The areas under the ROC curves of the EWIS was 0.929 and ≥ 4 points predicted infectious diseases, and the Kappa values were 0.750. As the score increased, the incidence of infectious diseases increased. The areas under the ROC curves of the EWIS predicting on single viral and bacterial infectious diseases were 0.961 and 0.896, and the Kappa values were 0.807 and 0.701, respectively.
Risk factors for infections have been identified, quantified and formulated into a table of EWIS that have high diagnostic accuracy and reliability for the early identification of contagious diseases.
背景、目的和目标：急性发热是传染病最常见的临床症状。有必要确定患有急性发热的传染病患者的危险因素，并制定早期预警传染性评分系统（EWIS）的激活标准，以提醒门诊医生。
采用逻辑回归分析，从 758 例急性发热患者的临床资料中确定传染病的危险因素。对危险因素进行加权，并制定 EWIS。对加权累积评分进行受试者工作特征（ROC）分析，以评估 EWIS 的诊断准确性，并使用 Kappa 检验确认诊断可靠性。采用 χ(2) -趋势检验确定 EWIS 与传染病发病率之间的相关性。
感染的危险因素包括结膜充血、皮疹、腹泻、丙氨酸氨基转移酶升高、脾肿大和外周中性粒细胞（NE%）异常。对危险因素进行加权并列表。EWIS 的 ROC 曲线下面积为 0.929，≥4 分预测传染病，Kappa 值为 0.750。随着分数的增加，传染病的发病率增加。EWIS 预测单一病毒性和细菌性传染病的 ROC 曲线下面积分别为 0.961 和 0.896，Kappa 值分别为 0.807 和 0.701。
确定了感染的危险因素，并将其量化并制定成 EWIS 表，用于早期识别传染病，具有较高的诊断准确性和可靠性。
