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Prognosis Sepsis - for Patient in Resource-Limited Setting

Purpose: To evaluate a patient presenting with sepsis in a resource-limited setting using the prognostic index of Asiimwe et al.

Description

Asiimwe et al developed a simple index for predicting prognosis for a patient with sepsis based on admission vital signs. This can be helpful in a resource-limited setting where other measures are not available. The authors are from Mbarara Regional Referral Hospital in Uganda.


 

Patient selection: adult with sepsis

 

Outcome: mortality

 

Parameters at the time of admission:

(1) respiratory rate in breaths per minute

(2) mean arterial pressure in mm Hg

(3) body temperature in °C

(4) pulse in beats per minute

(5) Glasgow coma score (GCS)

 

mean arterial pressure =

= ((systolic blood pressure) + (2 * (diastolic blood pressure))) / 3

 

Parameter

Finding

Points

respiratory rate

< 30 breaths per minute

0

 

>= 30 breaths per minute

1

mean arterial pressure

< 70 mm Hg

1

 

70 to 109

0

 

>= 110

1

body temperature

< 35.6°C

1

 

35.6 to 38.5 °C

0

 

>= 38.6°C

1

pulse

< 100 beats per minute

0

 

>= 100 beats per minute

1

Glasgow coma score

15

0

 

altered mental status (<= 14)

1

 

score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• The greater the score the worse the prognosis.

• A score >= 3 indicates an increased mortality rate (odds ratio 2.3 to 3.4).

 

Score

Mortality

0

11 to 33%

1

6 to 27%

2

16 to 25%

3

34 to 36%

4

33 to 42%

5

83 to 100%

 


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Specialty

Objective

ICD-10