Theerawit et al developed a simple score for predicting survival in a shock patient. These can help to identify a patient who may benefit from more aggressive management. The authors are from Mahidol University in Bangkok, Thailand.
Parameters during the first 24 hours after admission:
(1) pH of arterial blood
(2) heart rate in beats per minute
(3) serum creatinine in mg/dL (table says mmol/L but values are inconsistent)
(4) Glasgow Coma Score (GCS)
Parameter
Finding
Points
arterial pH
> 7.24
0
<= 7.24
1
heart rate
<= 130 beats per minute
0
> 130 beats per minute
1
serum creatinine
<= 1.5 mg/dL
0
> 1.5 mg/dL
1
Glasgow Coma Score
8 to 15
0
3 to 7
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the mortality rate.
• A cutoff >= 2 was used in the study.
Score
Mortality Rate
0
9%
1
21%
2
54%
3
76%
4
100%
Performance:
• The area under the ROC was 0.82.
• The positive predictive value for survival with a score < 2 was 83%.
• The prognosis is affected by the quality of care, the etiology of the shock, and how reversible it is.
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