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The ALT-70 cellulitis model maintains predictive value at 24 and 48 hours after presentation
Sean Singer1, David G Li2, Nicole Gunasekera3
1Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Background:
Cellulitis has many potential mimickers, and its misdiagnosis often leads to unnecessary hospitalizations and higher health care costs. The ALT-70 predictive model offers an objective tool to help differentiate between cellulitis and other clinically similar conditions at the time of initial emergency department (ED) presentation.
Objective:
To evaluate the performance of the ALT-70 predictive model at 24 and 48 hours following ED presentation.
Methods:
We performed a retrospective review of our prior cohort and expanded our data collection to include data at 24 and 48 hours after initial ED presentation. We compared classification measures for the ALT-70 at the time of initial ED presentation, 24 hours after presentation, and 48 hours after presentation.
Results:
There was a statistically significant difference in median ALT-70 score between patients with true cellulitis and those with mimickers of cellulitis at all time points. Sensitivity, specificity, positive predictive value, and negative predictive value of the ALT-70 score was similar across all 3 time points.
Limitations:
Single-center design may reduce generalizability.
Conclusion:
At 24 and 48 hours, the ALT-70 performed similarly to the way it performed at the time of initial ED presentation, allowing for its use in a wider array of clinical settings.
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