Claassen et al developed a physiological derangement score for evaluating patients with subarachnoid hemorrhage. This can help to stratify patients by prognosis soon after admission to the hospital. The authors are from Columbia University in New York City.
Parameters (most abnormal during the first 24 hours after hospital admission):
(1) arterio-alveolar oxygen gradient in mm Hg
(2) bicarbonate in mmol/L from the arterial blood gas
(3) serum glucose in mg/dL
(4) mean arterial pressure (MAP) in mm Hg
|
Parameter |
Finding |
Points |
|
arterio-alveolar oxygen gradient |
<= 125 mm Hg |
0 |
|
|
> 125 mm Hg |
3 |
|
HCO3 |
< 20 mmol/L |
2 |
|
|
>= 20 mm Hg |
0 |
|
serum glucose |
<= 180 mg/dL |
0 |
|
|
> 180 mg/dL |
2 |
|
mean arterial pressure |
< 70 mm Hg |
1 |
|
|
70 to 130 mm Hg |
0 |
|
|
> 130 mm Hg |
1 |
where:
• The arterio-alveolar oxygen gradient = (arterial PaO2 in mm Hg) - (alveolar O2 in mm Hg).
• mean arterial pressure = (((systolic blood pressure) + (2 * (diastolic pressure)))/3)
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the worse the prognosis.
|
Total Score |
Severe Disability or Death at 3 Months |
|
0 |
18% |
|
1 |
30% |
|
2 |
33% |
|
3 |
39% |
|
4 |
59% |
|
5 |
75% |
|
6 |
79% |
|
7 |
100% |
|
8 |
87% |
Specialty: Neurology
