Castellanos-Ortega et al developed a scoring system for predicting the prognosis for a child with meningococcal septic shock. This can help identify a child who may benefit from more aggressive management or novel therapies. The authors are from multiple university hospitals in Spain.
Parameters:
(1) refractory hypotension
(2) base deficit (opposite of base excess)
(3) Glasgow Coma Scale
(4) leukocyte count
(5) aPTT
(6) cyanosis
(7) oliguria
|
Parameter |
Finding |
Points |
|
refractory hypotensions |
absent |
0 |
|
|
present |
2 |
|
base deficit |
<= 10 mmol/L |
0 |
|
|
> 10 mmol/L (severe acidosis) |
1 |
|
Glasgow Coma score |
8 to 15 |
0 |
|
|
3 to 7 |
2 |
|
leukocyte count |
>= 4,000 per µL |
0 |
|
|
< 4,000 per µL |
1 |
|
aPTT |
<= 1.5 times control |
0 |
|
|
> 1.5 times control |
1 |
|
cyanosis |
absent |
0 |
|
|
present |
2 |
|
oliguria |
absent |
0 |
|
|
present |
1 |
where:
• Several of the parameters are indicators for multiple organ failure.
• I will use the upper limit of reference range for the aPTT in the implementation rather than a control value in the implementation. Alternatively the mean of the reference range could be used, but this would only be a minor elevation in some laboratories.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the worse the prognosis.
|
Total Score |
Risk Group |
Probability of Death |
|
0 to 3 |
low |
3% |
|
4 or 5 |
intermediate |
26% |
|
6 to 10 |
high |
74% |
Specialty: Infectious Diseases, Pulmonology, Neurology
ICD-10: ,
