Alt_70_score_for_cellulitis_guideline v.1
Developed to assist with evaluation of lower extremity redness, which may be inappropriately diagnosed as cellulitis (versus mimickers, or “pseudocellulitis”). Most patients with cellulitis have acute onset, unilateral involvement (usually one leg), and are sick with an elevated white blood cell count, tachycardia, and/or a fever. Predicts likelihood of lower extremity cellulitis over other diagnoses. Adult patients presenting to the ED with a red leg and clinical concern for cellulitis. Variable and points: Asymmetric: no=0, yes= 3 Age ≥70 years: no=0, yes= 2 WBC in ED ≥10,000/µL: no=0, yes= 1 HR in ED ≥90 bpm: no=0, yes= 1 Alt 70 score for cellulitis=Addition of the selected points Interpretation: ALT-70 Scores and related recommendations: 0-2=Reassess (>83.3% likelihood of pseudocellulitis) 3-4=Consult dermatology and/or infectious disease 5-7=Treat (>82.2% likelihood of true cellulitis)
Predicts likelihood of lower extremity cellulitis over other diagnoses.
Adult patients presenting to the ED(Emergency Department) with a red leg and clinical concern for cellulitis.
Can not be used in any of the following conditions: Visible abscess/fluctuance. Penetrating trauma. Burn. Diabetic ulcer. Implanted hardware/device. Post-operative patient. Recent (within 48 hours) IV antibiotic use.
Primary reference Raff, A. B., Weng, Q. Y., Cohen, J. M., Gunasekera, N., Okhovat, J. P., Vedak, P., ... and Mostaghimi, A. (2017). A predictive model for diagnosis of lower extremity cellulitis: a cross-sectional study. Journal of the American Academy of Dermatology, 76(4), 618-625. Validation Li, D. G., Dewan, A. K., Di Xia, F., Khosravi, H., Joyce, C., & Mostaghimi, A. (2018). The ALT-70 predictive model outperforms thermal imaging for the diagnosis of lower extremity cellulitis: A prospective evaluation. Journal of the American Academy of Dermatology, 79(6), 1076-1080. Singer, S., Li, D. G., Gunasekera, N., Okhovat, J. P., Vedak, P., Weng, C., ... & Mostaghimi, A. (2019). The ALT-70 cellulitis model maintains predictive value at 24 and 48 hours after presentation. Journal of the American Academy of Dermatology, 81(6), 1252-1256.
OBSERVATION.alt_70_score_for_cellulitis.v0, OBSERVATION.basic_demographic.v1, EVALUATION.alt_70_score_for_cellulitis.v0
