Kellett and Deane developed a simple clinical score that predicts 30-day mortality for a patient admitted to an acute medical service. The authors are from Nenagh Hospital in Ireland.
Parameters as seen on admission:
(1) age and gender
(2) systolic blood pressure
(3) pulse
(4) body temperature
(5) respiratory rate in breaths per minute
(6) oxygen saturation
(7) breathlessness on presentation
(8) ECG
(9) diabetes mellitus
(10) coma or altered mental status
(11) new stroke on presentation
(12) ability to stand or nursing home residence
(13) part of time spent in bed prior to onset of current illness (ECOG 2 to 4)
Parameter |
Finding |
Points |
---|---|---|
age and gender |
< 50 years old and male |
0 |
|
50 to 75 years old and male |
2 |
|
> 75 years old and male |
4 |
|
< 55 years old and female |
0 |
|
55 to 75 years old and female |
2 |
|
> 75 years old and female |
4 |
systolic blood pressure |
< 70 mm Hg |
4 |
|
70 to 80 mm Hg |
3 |
|
81 to 100 mm Hg |
2 |
|
> 100 mm Hg |
0 |
pulse rate |
pulse <= systolic blood pressure |
0 |
|
pulse > systolic blood pressure |
2 |
temperature |
< 35°C |
2 |
|
35 to 38.9°C |
0 |
|
>= 39°C |
2 |
respiratory rate |
<= 20 breaths per minute |
0 |
|
21 to 30 breaths per minute |
1 |
|
> 30 breaths per minute |
2 |
oxygen saturation |
< 90% |
2 |
|
90 to 94.9% |
1 |
|
>= 95% |
0 |
breathlessness at presentation |
no |
0 |
|
yes |
1 |
ECG |
normal |
0 |
|
abnormal |
2 |
diabetes mellitus |
absent |
0 |
|
present |
1 |
mental status |
coma not due to intoxication or overdose |
4 |
|
altered mental status without coma, not due to intoxication or overdose, and age >= 50 years |
2 |
|
other |
0 |
new stroke on presentation |
no |
0 |
|
yes |
3 |
standing or nursing home |
unable to stand unaided |
2 |
|
nursing home resident |
2 |
|
other |
0 |
time in bed prior to current illness |
no |
0 |
|
yes |
2 |
where:
• The oxygen saturation probably is based on breathing room air.
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: 31
• The higher the score the greater the 30-day mortality.
Total Score |
30-Day Mortality Risk |
Percent Mortality |
---|---|---|
0 to 3 |
very low risk |
0 |
4 or 5 |
low risk |
1.5% |
6 or 7 |
average risk |
4% |
8, 9, 10 or 11 |
high risk |
10% |
>= 12 |
very high risk |
30% |
after Figures 1 and 2. page 779
Purpose: To evaluate a patient admitted to an acute medical service using the simple clinical score of Kellett and Deane.
Objective: severity, prognosis, stage, prevention, public health
ICD-10: Z51.9,