shapiro_rule_bacteremia: Shapiro Rule for Bacteremia

In cliot: Clinical Indices and Outcomes Tools

Shapiro Rule for Bacteremia

Description

Calculates the Shapiro Rule result to determine if blood cultures are indicated for a febrile patient in the emergency department. The rule identifies patients at high risk for bacteremia based on major and minor criteria. Blood cultures are recommended if at least one Major criterion or at least two Minor criteria are present.

Usage

shapiro_rule_bacteremia(age, shaking_chills, vomiting, temperature_c, systolic_bp,
                        wbc_count, creatinine, bands_percent, platelet_count,
                        suspected_endocarditis, indwelling_vascular_catheter)

Arguments

age	Numeric. Patient age in years. (> 65 years is a Minor criterion).
shaking_chills	Numeric (0 or 1). Presence of shaking chills (rigors). (1 = Yes, Minor criterion).
vomiting	Numeric (0 or 1). Presence of vomiting. (1 = Yes, Minor criterion).
temperature_c	Numeric. Body temperature in degrees Celsius. (> 39.4 C is a Major criterion).
systolic_bp	Numeric. Systolic blood pressure in mmHg. (< 90 mmHg is a Minor criterion).
wbc_count	Numeric. White blood cell count in cells/uL. (> 18,000 is a Minor criterion).
creatinine	Numeric. Serum creatinine in mg/dL. (> 2.0 mg/dL is a Minor criterion).
bands_percent	Numeric. Percentage of band forms (neutrophils). (> 5% is a Minor criterion).
platelet_count	Numeric. Platelet count in cells/uL. (< 150,000 is a Minor criterion).
suspected_endocarditis	Numeric (0 or 1). Clinical suspicion of endocarditis. (1 = Yes, Major criterion).
indwelling_vascular_catheter	Numeric (0 or 1). Presence of an indwelling vascular catheter. (1 = Yes, Major criterion).

Value

A list containing:

Recommendation	Guidance on whether blood cultures are indicated.
Major_Criteria_Met	Count of major criteria met.
Minor_Criteria_Met	Count of minor criteria met.

References

Shapiro NI, Wolfe RE, Wright SB, Moore R, Bates DW. Who needs a blood culture? A prospectively derived and validated prediction rule. J Emerg Med. 2008;35(3):255-264. doi:10.1016/j.jemermed.2007.08.056

Examples

# Example 1: Indicated (1 Major)
# Suspected Endocarditis
shapiro_rule_bacteremia(40, 0, 0, 38.0, 120, 10000, 1.0, 0, 200000, 1, 0)

# Example 2: Indicated (2 Minor)
# Age 70, Vomiting
shapiro_rule_bacteremia(70, 0, 1, 38.0, 120, 10000, 1.0, 0, 200000, 0, 0)

# Example 3: Not Indicated
# 40yo, Fever 38.5, no other signs
shapiro_rule_bacteremia(40, 0, 0, 38.5, 120, 10000, 1.0, 0, 200000, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.