Nagula et al developed a colon obstruction score (COS) to evaluate patients with malignant colorectal obstruction. This can be used to monitor a patient's response to interventions to relieve the obstruction. The authors are from Memorial Sloan Kettering Cancer Center and the University of Calgary.
Parameters:
(1) abdominal pain using a 10 cm VAS anchored from 0 (none) to 10 (extreme)
(2) abdominal distention
(3) frequency of bowel movements
(4) nausea
(5) vomiting
|
Parameter |
Finding |
Points |
|
abdominal pain |
<1 cm |
0 |
|
|
1 to 3.99 cm |
1 |
|
|
4 to 6.99 cm |
2 |
|
|
>= 7 cm |
3 |
|
abdominal distention |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
frequency of bowel movements |
> 8 per day |
3 |
|
|
4 to 8 per day |
2 |
|
|
2-3 per day |
1 |
|
|
1 per day |
0 |
|
|
none for 2 days |
1 |
|
|
none for 3 days |
2 |
|
|
none for >= 4 days |
3 |
|
nausea |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
vomiting |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
where:
• The original table has a 0 cm the VAS scale as indicating mild abdominal pain. A VAS usually uses 0 for none.
• The original table has a frequency for bowel movements of 2-3 per day as 0 points and 1 per day as 1 point.
total score =
= SUM(points all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the more severe the obstruction.
|
Total Score |
Obstructive Symptoms |
|
0 |
no |
|
1 to 5 |
mild |
|
6 to 10 |
moderate |
|
11 to 15 |
severe |
Specialty: Gastroenterology
