Oza Shefali, Sesay Alieu A, Russell Neal J, Wing Kevin, Boufkhed Sabah, Vandi Lahai, Sebba Sahr C, Cummings Rachael, Checchi Francesco
Emerg Infect Dis. 2017 Nov;23(11):1792-1799. doi: 10.3201/eid2311.170171.
Rapidly identifying likely Ebola patients is difficult because of a broad case definition, overlap of symptoms with common illnesses, and lack of rapid diagnostics. However, rapid identification is critical for care and containment of contagion. We analyzed retrospective data from 252 Ebola-positive and 172 Ebola-negative patients at a Sierra Leone Ebola treatment center to develop easy-to-use risk scores, based on symptoms and laboratory tests (if available), to stratify triaged patients by their likelihood of having Ebola infection. Headache, diarrhea, difficulty breathing, nausea/vomiting, loss of appetite, and conjunctivitis comprised the symptom-based score. The laboratory-based score also included creatinine, creatine kinase, alanine aminotransferase, and total bilirubin. This risk score correctly identified 92% of Ebola-positive patients as high risk for infection; both scores correctly classified >70% of Ebola-negative patients as low or medium risk. Clinicians can use these risk scores to gauge the likelihood of triaged patients having Ebola while awaiting laboratory confirmation.
由于病例定义宽泛、症状与常见疾病重叠以及缺乏快速诊断方法，快速识别可能感染埃博拉病毒的患者具有一定难度。然而，快速识别对于患者治疗和疫情控制至关重要。我们分析了来自塞拉利昂一家埃博拉治疗中心的252例埃博拉病毒检测呈阳性患者和172例检测呈阴性患者的回顾性数据，基于症状和实验室检查结果（若有）制定了易于使用的风险评分，以便根据分诊患者感染埃博拉病毒的可能性对其进行分层。头痛、腹泻、呼吸困难、恶心/呕吐、食欲不振和结膜炎构成了基于症状的评分指标。基于实验室检查结果的评分指标还包括肌酐、肌酸激酶、谷丙转氨酶和总胆红素。该风险评分正确识别出92%的埃博拉病毒检测呈阳性患者为高感染风险；两个评分指标均正确地将超过70%的埃博拉病毒检测呈阴性患者归类为低风险或中等风险。临床医生可以在等待实验室确诊期间，利用这些风险评分来评估分诊患者感染埃博拉病毒的可能性。
