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Oncological PRISM Score (O-PRISM)

Purpose: To calculate the O-PRISM score for a pediatric patient with cancer who being treated in the intensive care unit (ICU).

Description

Schneider et al developed the oncological PRISM Score (O-PRISM) as an extension of the original PRISM score. This can be used to evaluate children in the ICU who have undergone stem cell transplantation. The authors are from Children's Hospital at Heinrich Heine University in Dusseldorf.


Components of O-PRISM:

(1) PRISM score (14 items, see 30.17.01)

(2) macroscopic bleeding

(3) graft-vs-host disease (GVHD)

(4) C-reactive protein in mg/dL

 

Parameter

Finding

Points

macroscopic bleeding

no

0

 

yes

4

GVHD

none

0

 

Grade 1

0

 

Grade 2

2

 

Grade 3 or 4

4

C-reactive protein (CRP)

<= 10 mg/dL

0

 

> 10 mg/dL

4

 

where:

• A number of discrepancies in scoring are seen. For example, in the Summary and Table 2 the CRP is scored as > 10 while at several references in the text it is >= 10. For systolic blood pressure in a child a range is given as 66-75 while in the original table it is 65-75.

 

O-PRISM =

= SUM(points for the original 14 parameters for the PRISM score) + SUM(points for additional 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 76 + 12 = 88

• The higher the O-PRISM score the greater the mortality.

• According to the study of Gonzalez-Vicent et al, an O-PRISM score > 10 was associated with a poor prognosis in pediatric patients who underwent a hematopoietic stem cell transplant.


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Specialty

Objective

ICD-10