Helbok et al describe a score for predicting mortality in African children with Plasmodium falciparum malaria based on a number of organ dysfunctions. This is a simple way to identify a patient who is at higher risk and who may benefit from more aggressive management. The authors are from Albert Schweitzer Hospital (Lambarene, Gabon), the University of Health Sciences Libreville (Gabon), and universities in Austria, Germany, Kenya, England, Ghana and The Gambia.
Patient selection: African child with Plasmodium falciparum malaria
Parameters:
(1) level of consciousness
(2) prostration
(3) breathing
Parameter
Finding
Points
level of consciousness
non-comatose
0
comatose
1
prostration
absent
0
present
1
breathing
not deep
0
deep
1
where:
• Prostration indicates an inability to do any of the following: breast feed, walk, stand or sit.
• Coma was a Blantyre Come Score <= 2.
LODS =
= SUM(points for all 3 parameters)
Interpretation:
• minimum LODS: 0
• maximum LODS: 3
• The higher the score the greater the risk for mortality.
LODS
Mortality Rate
0
1%
1
3%
2
11%
3
30%
from Figure 3 page 1840.
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