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Glasgow Meningococcal Septicemia Prognostic Score

Purpose: To use the Glasgow Meningococcal Septicemia Prognosis Score to identify a child with meningococcemia who is at high risk for mortality.

Description

The Glasgow Meningococcal Septicemia Prognostic Score (GMSPS) can identify children with meningococcemia who are at significant risk of mortality. These children can be triaged for more intensive care.


Patient populations:

(1) pediatric patients seen in Glasgow, Scotland and subsequently Liverpool, England

(2) children had meningococcemia with or without meningitis

 

Parameter

Finding

Points

systolic blood pressure

< 75 mm Hg if age < 4 years; < 85 mm Hg if >= 4 years of age

3

 

>= 75 mm Hg if age < 4 years; >= 85 mm Hg if >= 4 years of age

0

skin-to-rectal temperature difference

> 3 °C

3

 

<= 3 °C

0

modified coma scale score

< 8, or deterioration >= 3 points in one hour

3

 

>=8 and deterioration < 3 points

0

deterioration in hour before scoring

present

2

 

absent (stable in hour before scoring)

0

absence of meningism

present

2

 

absent (meningism present)

0

rash

extending purpura, or widespread ecchymoses

1

 

 

0

base deficit (capillary or arterial)

> 8.0

1

 

<= 8.0

0

 

Glasgow Meningococcal Septicemia Prognostic Score =

= SUM (points for all 7 parameters)

 

Modified Coma Scale

 

Parameter

Finding

Points

eye opening

spontaneously

4

 

to speech

3

 

to pain

2

 

none

1

best verbal response

orientated

6

 

words

4

 

verbal sounds

3

 

cries

2

 

none

1

best motor response

obeys commands

6

 

localizes pain

4

 

moves to pain

1

 

none

0

 

modified coma scale =

= (points for eye opening) + (points for best verbal response) + (points for best motor response)

 

Interpretation:

• minimum GMSPS score: 0

• maximum GMSPS score: 15

• cutoff score for predicting mortality could be present at admission or during hospitalization

 

Cutoff Score for Mortality

Sensitivity

Specificity

Positive Predictive Value

Negative Predictive Value

>= 8

100%

95%

74%

100%

>= 9

100%

95%

74%

100%

>= 10

100%

98%

88%

100%

 


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Specialty

Objective

ICD-10