Henry et al reported two scores for a patient with malignant bowel obstruction. These can help to guide management. The authors are from the Ohio State University in Columbus.
Parameters::
(1) carcinomatosis
(2) WBC count
(3) serum albumin
(4) nongynecologic cancer
(5) complete small bowel obstruction
(6) ascites
Parameter
Finding
Management
30-Day Mortality
carcinomatosis
no
0
0
yes
1
1
WBC count
normal
0
0
leukocytosis
1
1
serum albumin
normal
1
0
decreased
0
1
nongynecologic cancer
no
0
0
yes
1
0
complete small bowel obstruction
no
0
0
yes
0
1
ascites
no
0
0
yes
0
1
total score for management =
= SUM(points for 4 parameters)
total score for 30-day mortality =
= SUM(points for 5 parameters)
Interpretation:
• minimum total scores: 0
• maximum management score: 4
• maximum 30-day mortality score 5
30-Day Mortality
Complete Small Bowel Obstruction
Management Score
Recommend
4 or 5
NA
NA
no surgery, palliative care
0 to 3
no
NA
surgery
0 to 3
yes
0 or 1
surgery
0 to 3
yes
2
case by case basis
0 to 3
yes
3 or 4
no surgery, palliative care
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