_id

683a163cc782e11e38d1b2b0

id

10218

title

ATLAS Score for Clostridium Difficile Infection

full_title

ATLAS Score for Clostridium Difficile Infection

short_title

ATLAS Score for C. Diff. Colitis

med_description

Predicts response to therapy in patients with C. diff.

short_description

C. diff therapy response.

slug

atlas-score-clostridium-difficile-infection

description

The ATLAS Score for Clostridium Difficile Infection predicts response to therapy in patients with C. diff.

keywords

Atlas, c. diff. Colitis, c diff, c diff Colitis, atlas score, Clostridium Difficile Infection

complaint

[ "Abdominal Pain", "Diarrhea", "Fever" ]

formula

Addition of the selected points: *Note: the original validation (Miller 2013) examined 6 parameters: age, temperature, leukocyte count, albumin, serum creatinine, and systemic antibiotics. The combination of parameters which led to the greatest discrimination among risk groups and correlation with cure was the five excluding temperature, and MDCalc uses this version for that reason.

evidence

measurements

[]

information

Interpretation:

Cure rate from Miller 2013 and mortality from Miller 2010.

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-148", "text": "Miller MA, Louie T, Mullane K, et al. Derivation and validation of a simple clinical bedside score (ATLAS) for Clostridium difficile infection which predicts response to therapy. BMC Infect Dis. 2013;13:148." } ], "Other References": [ { "href": "https://idsa.confex.com/idsa/2010/webprogram/Paper4263.html", "text": "Miller MA. ATLAS - A Bedside Scoring System Predicting Mortality Due to Clostridium Difficile Infection (CDI) in Elderly Hospitalized Patients. 48th IDSA Annual Meeting. 2010;P452." }, { "href": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265469/ ", "text": "Abou Chakra CN, Pepin J, Valiquette L. Prediction tools for unfavourable outcomes in Clostridium difficile infection: a systematic review. PLoS ONE. 2012;7(1):e30258." }, { "href": "https://www.sciencedirect.com/science/article/pii/S1413867015001063", "text": "Hernández-García R, Garza-González E, Miller M, Arteaga-Muller G, Galván-De Los Santos AM, Camacho-Ortiz A. Application of the ATLAS score for evaluating the severity of Clostridium difficile infection in teaching hospitals in Mexico. Braz J Infect Dis. 2015;19(4):399-402." }, { "href": "https://jamanetwork.com/journals/jama/article-abstract/2091993 ", "text": "Bagdasarian N, Rao K, Malani PN. Diagnosis and treatment of Clostridium difficile in adults: a systematic review. JAMA. 2015;313(4):398-408." } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-148", "text": "Miller MA, Louie T, Mullane K, et al. Derivation and validation of a simple clinical bedside score (ATLAS) for Clostridium difficile infection which predicts response to therapy. BMC Infect Dis. 2013;13:148." } ], "Validations": [] }

pearls

• Scores correlate with cure rates; however, the correlation with recurrence was not statistically significant.
• Does not account for all markers of disease severity—for example, strain type was excluded since this information is not always readily available at diagnosis.
• Patients with life-threatening or fulminant disease were excluded from the derivation study, potentially leading to under-representation of patients at the upper extreme of score values.
• Note: Clostridium difficile is now referred to as Clostridioides difficile.

usecase

Use in patients diagnosed with C. difficile infection (CDI) at the time of diagnosis to stratify disease severity.

reasons

Useful for identifying patients with CDI who are at high risk for severe outcomes or mortality. Determining disease severity can aid in clinical decision-making for treatment intensity and level of care (e.g., outpatient versus inpatient management). Results can assist in discussions with patients and families about prognosis and treatment options.

next_advice

• No definitive management recommendations have been made based on ATLAS score results.
• For lower scores: Consider less intensive treatment and possible outpatient management, if the patient is clinically stable.
• For higher scores: Escalate care, potentially involving infectious disease consultation, hospitalization, or ICU care if warranted.
• Use alongside clinical judgment; the score complements, but does not replace, bedside evaluation.

next_actions

next_management

For detailed treatment recommendations, please refer to clinical guidelines from the American College of Gastroenterology, the American Society of Colon and Rectal Surgeons, and the Infectious Disease Society of America/Society for Healthcare Epidemiology of America.

diseases

[ "Sepsis" ]

input_schema

[ { "conditionality": "", "default": 0, "label_en": "<p><span style=\"text-decoration: underline;\"><strong>A</strong></span>ge, years</p>", "mdcalc_info_concept": null, "name": "age", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<60", "value": 0 }, { "label": "60-79", "value": 1 }, { "label": "≥80", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p><strong><span style=\"text-decoration: underline;\">T</span></strong>reatment with systemic antibiotics during C. diff infection therapy</p>", "md_calc_info_concept": null, "name": "treat", "option_fhir_rules": null, "optional": false, "options": [ { "label": "No", "value": 0 }, { "label": "Yes", "value": 2 } ], "show_points": true, "tips_en": "≥1 day duration", "type": "toggle" }, { "conditionality": "", "default": 0, "label_en": "<p><span style=\"text-decoration: underline;\"><strong>L</strong></span>eukocyte count, cells/&micro;L</p>", "mdcalc_info_concept": null, "name": "leuk", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<16,000", "value": 0 }, { "label": "16,000-25,000", "value": 1 }, { "label": ">25,000", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p>Serum <strong><span style=\"text-decoration: underline;\">a</span></strong>lbumin</p>", "mdcalc_info_concept": null, "name": "alb", "option_fhir_rules": null, "optional": false, "options": [ { "label": ">3.5 g/dL (>35 g/L)", "value": 0 }, { "label": "2.6-3.5 g/dL (26-35 g/L)", "value": 1 }, { "label": "<2.6 g/dL (<26 g/L)", "value": 2 } ], "show_points": true, "tips_en": "", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "<p><span style=\"text-decoration: underline;\"><strong>S</strong></span>erum creatinine</p>", "mdcalc_info_concept": null, "name": "cr", "option_fhir_rules": null, "optional": false, "options": [ { "label": "≤1.3 mg/dL (≤120 μmol/L)", "value": 0 }, { "label": "1.4-2.0 mg/dL (121-179 μmol/L)", "value": 1 }, { "label": "≥2.1 mg/dL (≥180 μmol/L)", "value": 2 } ], "show_points": true, "tips_en": "As a measure of renal function", "type": "radio" } ]

instructions

published

2022-04-21T20:28:35.864Z

purpose

[ "Prognosis" ]

search_terms

[ "Atlas", "c. diff. Colitis", "c diff", "c diff Colitis", "atlas score", "Clostridium Difficile Infection" ]

seo

{ "keywords_en": "Atlas, c. diff. Colitis, c diff, c diff Colitis, atlas score, Clostridium Difficile Infection", "meta_description_en": "The ATLAS Score for Clostridium Difficile Infection predicts response to therapy in patients with C. diff." }

specialty

[ "Family Practice", "Gastroenterology", "Hospitalist Medicine", "Internal Medicine", "Primary Care" ]

departments

[ "Gastrointestinal", "Infectious" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10512, "short_title_en": "Travis Criteria", "slug": "travis-criteria" }, { "calcId": 10511, "short_title_en": "Ho Index", "slug": "ho-index" }, { "calcId": 10519, "short_title_en": "Menza Score", "slug": "menza-score" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "gastroenterology", "infectious" ]

cleaned_use

[ "Use in patients diagnosed withC. difficileinfection (CDI) at the time of diagnosis to stratify disease severity." ]

pub

false