cliot (version 1.0.0)

newsom_chest_pain_score: Newsom Score for Non-Traumatic Chest Pain (CXR Rule)

Description

Calculates the Newsom Score to determine the necessity of a chest radiograph (CXR) in patients presenting to the emergency department with non-traumatic chest pain. The rule identifies patients at low risk for significant intrathoracic pathology (e.g., pneumonia, heart failure, pneumothorax, malignancy) who may be safely managed without a chest x-ray.

Usage

newsom_chest_pain_score(age, history_chf, history_smoking, hemoptysis,
                        history_tuberculosis, history_thromboembolism,
                        alcohol_abuse, temp_c, oxygen_saturation,
                        respiratory_rate, diminished_breath_sounds, rales)

Value

A list containing:

Newsom_Score

The total count of positive criteria.

Risk_Category

"Low Risk" if score is 0, otherwise "Not Low Risk".

Recommendation

Clinical guidance regarding the need for a Chest X-ray.

Arguments

age

Numeric. Patient age in years. (Age >= 60 adds 1 point).

history_chf

Numeric (0 or 1). History of Congestive Heart Failure. (1 = Yes).

history_smoking

Numeric (0 or 1). History of smoking. (1 = Yes).

hemoptysis

Numeric (0 or 1). Presence of hemoptysis. (1 = Yes).

history_tuberculosis

Numeric (0 or 1). History of tuberculosis. (1 = Yes).

history_thromboembolism

Numeric (0 or 1). History of thromboembolic disease (DVT/PE). (1 = Yes).

alcohol_abuse

Numeric (0 or 1). Prior or current alcohol abuse. (1 = Yes).

temp_c

Numeric. Body temperature in degrees Celsius. (>= 38.0 C adds 1 point).

oxygen_saturation

Numeric. Oxygen saturation percentage (SpO2). (< 90% adds 1 point).

respiratory_rate

Numeric. Respiratory rate in breaths per minute. (> 24 bpm adds 1 point).

diminished_breath_sounds

Numeric (0 or 1). Diminished breath sounds on auscultation. (1 = Yes).

rales

Numeric (0 or 1). Presence of rales/crackles on auscultation. (1 = Yes).

References

Newsom C, et al. A clinical prediction rule for ordering chest radiographs in patients with non-traumatic chest pain. (Study validated in emergency settings).

Examples

# Example 1: Low Risk (No CXR needed)
# 45yo, No history, Normal vitals, Clear lungs
newsom_chest_pain_score(45, 0, 0, 0, 0, 0, 0, 37.0, 98, 16, 0, 0)

# Example 2: Not Low Risk (CXR indicated)
# 70yo (+1), Hx CHF (+1), Rales (+1)
newsom_chest_pain_score(70, 1, 0, 0, 0, 0, 0, 37.0, 95, 20, 0, 1)