Mohapatra and Das reported the Malaria Severity Score (MSS) for a patient with malaria. This can help to identify a patient who may benefit from more aggressive management. The authors are from V.S.S Medical College and M.K.C.G. Medical College in India.
Patient selection: malaria
Parameters:
(1) neurologic (Glasgow coma scale)
(2) renal (BUN, serum creatinine, urine output)
(3) cardiovascular (heart rate, systolic blood pressure)
(4) respiratory (respiratory rate)
(5) hematologic (hemoglobin, platelet count, total leukocyte count)
(6) hepatic (serum bilirubin)
(7) metabolic (blood glucose)
|
Parameter |
Finding |
Points |
|
GCS |
14 or 15 |
0 |
|
|
10 to 13 |
1 |
|
|
7 to 9 |
3 |
|
|
3 to 6 |
5 |
|
BUN |
<=36 mg/dL |
0 |
|
|
37 to 59 mg/dL |
1 |
|
|
60 to 119 mg/dL |
3 |
|
|
>= 120 mg/dL |
5 |
|
creatinine |
<= 1.2 mg/dL |
0 |
|
|
1.3 to 1.9 mg/dL |
1 |
|
|
2.0 to 4.9 mg/dL |
3 |
|
|
>= 5.0 mg/dL |
5 |
|
urine output |
> 0.75 L/d |
0 |
|
|
0.5 to 0.75 L/d |
1 |
|
|
0.4 to 0.49 L/d |
3 |
|
|
< 0.4 L/d |
5 |
|
heart rate |
<= 50 beats per minute |
3 |
|
|
51 to 119 |
0 |
|
|
120 to 139 |
1 |
|
|
>= 140 beats per minute |
3 |
|
systolic blood pressure |
>= 90 mm Hg |
0 |
|
|
70 to 89 |
1 |
|
|
< 70 mm Hg |
3 |
|
respiratory rate |
<= 30 breaths/minute |
0 |
|
|
31 to 40 |
1 |
|
|
>= 41 breaths/minute |
3 |
|
hemoglobin |
>= 10 g/dL |
0 |
|
|
7.0 to 9.9 g/dL |
1 |
|
|
< 7.0 g/dL |
3 |
|
total leukocyte count |
<= 2,000 per µL |
3 |
|
|
2,001 to 4000 |
1 |
|
|
4,001 to 10,000 |
0 |
|
|
> 10,000 |
1 |
|
platelet count |
< 80,000 per µL |
1 |
|
|
>= 80,000 per µL |
0 |
|
serum bilirubin |
< 2.0 mg/dL |
0 |
|
|
>= 2.0 mg/dL |
1 |
|
blood glucose |
< 60 mg/dL |
1 |
|
|
>= 60 mg/dL |
0 |
where:
• The table above includes coverage of gaps in the original table.
total score =
= (points GCS) + MAX(renal markers) + MAX(cardiovascular) + (points for respiratory rate) + MAX(hematologic markers) + (points for bilirubin) + (points for glucose)
Interpretation:
• minimum score: 0
• maximum score: 21
|
Total Score |
Risk Level |
Mortality Rate |
|
<= 5 |
low |
< 40% |
|
6 to 11 |
intermediate |
40 to 80% |
|
>= 12 |
high |
> 80% |
Performance:
• The area under of the ROC curve is 0.91.
Specialty: Infectious Diseases
