Harooni et al reported a score for predicting mortality in a patient with Hirschsprung's disease associated enterocolitis (HDAEC). The authors are from DCMS (Deccan College of Medical Sciences) in Hyderabad, India.
Patient selection: Hirschsprung's disease associated enterocolitis
NOTE: This score is similar to the HAEC score of Pastor et al.
Parameters scored 2 points if present:
(1) fever
(2) bloody stool
(3) previous history of enterocolitis
(4) sudden deterioration
Parameters scored 1 point if present: :
(1) diarrhea with explosive stool
(2) diarrhea with foul-smelling stool
(3) explosive discharge of gas and stool on rectal exam
(4) distended abdomen
(5) decreased peripheral perfusion
(6) lethargy
(7) multiple air fluid levels on abdominal radiographs
(8) dilated loops of bowel on abdominal radiographs
(9) saw tooth appearance with irregular mucosal lining on abdominal radiographs
(10) cut-off sign in recto-sigmoid with absence of distal air
(11) pneumatosis
(12) leukocytosis
(13) "shift to left" in differential count
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
|
Total Score
|
Prognosis
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<= 10
|
survival
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|
11 to 15
|
survival with morbidity
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>= 16
|
mortality
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