Patient population:
(1) Patients with meningococcemia and/or meningococcal meningitis admitted to University Hospital, Tromso, Norway, over 4 year period.
(2) The age range was from 13 to 73 years.
|
Parameter
|
Finding
|
Points
|
|
ethanol gelation test
|
negative
|
0
|
|
|
positive
|
1
|
|
normotest
|
> 60%
|
0
|
|
|
<= 60%
|
1
|
|
NT/TT discrepancy
|
< 0.40
|
0
|
|
|
>= 0.40
|
1
|
|
platelet count per µL
|
> 100,000 per µL
|
0
|
|
|
< 100,000 per µL
|
1
|
|
plasma fibrinogen in mg/dL
|
> 100 mg/dL
|
0
|
|
|
<= 100 mg/dL
|
1
|
where:
• NT/TT discrepancy =
= ((normotest in percent) - (thrombotest in percent)) / (normotest in percent)
DIC score =
= SUM(points for 5 tests)
Interpretation:
• minimum score: 0
• maximum score: 5
• all fatal cases and 50% of nonfatal cases had DIC scores of 2 or more
Factors associated with poor prognosis in meningococcal disease:
(1) normotest < 50%
(2) platelet count < 100,000 per µL
(3) fibrinogen < 100 mg/dL
If there is a conversion from normotest results to prothrombin times, then this could be more widely used. I would imagine that the breakpoint may correspond to a PT > 150% of normal (Algren et al, above).
