Lener et al reported the MSI-20 score to evaluate a patient with a spinal infection. It can help to identify a patient at greater risk of mortality. The authors are from the Medical University of Innsbruck in Austria.
MSI is derived from mortality (M), spinal infection (SI) and the maximum score (20).
Patient selection: spinal infection prior to surgery
Parameters:
(1) body mass index (BMI) in kg per square meter
(2) ASA status
(3) septic clinical state
(4) age-adjusted Charlson comorbidity index (CCI)
(5) eGFR in mL per minute
(6) hepatopathy
(7) MRC muscle grade
(8) serum CRP at diagnosis in mg/dL
Parameter
Finding
Points
BMI
< 25 kg per sq m
0
25 to 30 kg per sq m
1
> 30 kg per sq m
2
ASA status
1 or 2
0
3
1
4
2
5
3
clinically septic
no
0
yes
4
age-adjusted CCI
0 to 4
0
5 to 7
1
>= 8
2
eGFR
>= 30 mL/min
0
15 to 29
2
< 15
4
hepatopathy
no
0
yes
1
MRC muscle grade
4 or 5
0
3
1
0 to 2
2
serum CRP
< 15 mg/dL
0
15 to 25 mg/dL
1
> 25 mg/dL
2
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• A score >= 11 is associated with poor status and the patient may be too sick to undergo surgery.
• A score <= 10 is an indication for early surgery.
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