EsVan Risk Assessment
Esbenshade/Vanderbilt (EsVan) Model
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Risk of Blood Stream Infection |
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Minimal Risk |
Intermediate Risk |
High Risk |
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Predicted Risk < 10% |
Predicted Risk 10 - < 40% |
Predicted Risk > 40% |
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Discharge home with no antibiotics and strict follow-up; primary team to follow-up by phone next day |
Administer ceftriaxone 50 mg/kg IV and discharge home |
Administer cefepime 50 mg/kg IV and admit to 4HH overnight for observation |
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References: Esbenshade, A.J., Zhao, Z., Gray, W., Hussain, L. (n.d.). Risk prediction model for the diagnosis of blood stream infection in febrile pediatric oncology patients without severe neutropenia. https://cqs.app.vumc.org/shiny/RiskPrediction/ Esbenshade, A. J., Pentima, M. C., Zhao, Z., Shintani, A., Esbenshade, J. C., Simpson, M. E., Montgomery, K. C., Lindell, R. B., Lee, H., Wallace, A., Garcia, K. L., Moons, K. G., & Friedman, D. L. (2015). Development and validation of a prediction model for diagnosing blood stream infections in febrile, non-neutropenic children with cancer. Pediatr Blood Cancer, 62(2), 262-268. https://doi.org/10.1002/pbc.25275 Esbenshade, A. J., Zhao, Z., Aftandilian, C., Saab, R., Wattier, R. L., Beauchemin, M., Miller, T. P., Wilkes, J. J., Kelly, M. J., Fernbach, A., Jeng, M., Schwartz, C. L., Dvorak, C. C., Shyr, Y., Moons, K. G. M., Sulis, M. L., & Friedman, D. L. (2017). Multisite external validation of a risk prediction model for the diagnosis of blood stream infections in febrile pediatric oncology patients without severe neutropenia. Cancer, 123(19), 3781-3790. https://doi.org/10.1002/cncr.30792 |
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