Mohapatra et al reported the GCRBS score for evaluating a patient with severe falciparum malaria. This can help to identify a patient who may benefit from more aggressive management. The authors are from SCB Medical College and Hi-tech Medical College in Odisha, India.
Patient selection: falciparum malaria
Parameters:
(1) Glasgow coma scale (GCS)
(2) serum creatinine (C) in mg/dL
(3) respiratory rate/respiratory distress (R) in breaths per minute
(4) serum total bilirubin (B) in mg/dL
(5) systolic blood pressure/shock (S)
Parameter
Finding
Points
Glasgow coma scale
11 to 15
0
7 to 10
1
3 to 6
3
serum creatinine
<= 3.0 mg/dL
0
> 3.0 mg/dL
2
respiratory rate
<= 24 breaths/minute
0
> 24 breaths/minute
2
serum total bilirubin
<= 10 mg/dL
0
> 10 mg/dL
2
systolic blood pressure
>= 90 mm Hg
0
< 90 m Hg
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 5 was associated with increased risk for mortality.
Performance:
• The cutoff of >= 5 had a sensitivity of 85% and specificity of 96%.
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