PASS Score of Westendorp et al for Predicting Risk of Nosocomial Infection Following an Acute Stroke

Description

Westendorp et al reported a score for predicting nosocomial infection in a patient with an acute stroke. A related score predicts the risk of post-stroke pneumonia. The authors are from multiple institutions in the Netherlands participating in the Preventive Antibiotics in Stroke Study (PASS).

Patient selection: adult with acute stroke

Outcome: post-stroke infection (including pneumonia)

Parameters:

(1) age in years

(2) sex

(3) history of COPD

(4) history of diabetes

(5) intracranial hemorrhage

(6) NIHSS for stroke severity

(7) dysphagia

(8) use of a bladder catheter

Parameter	Finding	Points
age	<= 50 years	0
	51 to 60 years	1
	61 to 70 years	2
	71 to 80 years	3
	> 80 years	4
sex	female	0
	male	-1
COPD	no	0
	yes	2
diabetes	no	0
	yes	1
intracerebral hemorrhage	no	0
	yes	1
NIHSS	0 to 5	0
	6 to 10	2
	11 to 20	4
	21 to 30	6
dysphagia	no	0
	yes	4
bladder catheter	no	0
	yes	6

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: -1

• maximum score: 24

Score	Risk Group	Pneumonia
<= 5	low	4%
6 to 10	moderate	11%
11 to 16	high	31%
17 to 24	very high	52%

Performance:

• The area under the ROC curve is 0.84.

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