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Sepsis in Obstetrics Score (SOS) for Evaluating a Septic Obstetrical Patient

Purpose: To evaluate an obstetrical patient with sepsis using the Sepsis in Obstetrics Score (SOS) of Albright et al.

Description

Albright et al developed the Sepsis in Obstetrics Score to evaluate pregnant women with sepsis. This can help to identify a patient who may require more aggressive management. The authors are from Women and Infants Hospital at Brown University in Providence, Rhode Island.


 

Patient selection: obstetric patient with sepsis

 

Parameters:

(1) body temperature in °C

(2) systolic blood pressure in mm Hg

(3) heart rate in beats per minute

(4) respiratory rate in breaths per minute

(5) oxygen saturation in percent (by pulse oximeter)

(6) white blood cell count per µL

(7) percent immature neutrophils

(8) lactic acid in mmol/L

 

Parameter

Finding

Points

body temperature

> 40.9°C

4

 

39 to 40.9°C

3

 

38.5 to 38.9°C

1

 

36 to 38.4°C

0

 

34 to 35.9°C

1

 

32 to 33.9°C

2

 

30 to 31.9°C

3

 

< 30°C

4

systolic blood pressure

> 90 mm Hg

0

 

70 to 90 mm Hg

2

 

< 70 mm Hg

4

heart rate

<= 119 beats per minute

0

 

120 to 129

1

 

130 to 149

2

 

150 to 179

3

 

> 179

4

respiratory rate

> 49 breaths per minute

4

 

35 to 49

3

 

25 to 34

1

 

12 to 24

0

 

10 or 11

1

 

6 to 9

3

 

<= 5

4

oxygen saturaion

>= 92%

0

 

90-91%

1

 

85 to 89%

3

 

< 85%

4

white blood cell count

> 39,9000 per µL

4

 

25,000 to 39,900 per µL

2

 

17,000 to 24,900 per µL

1

 

5,700 to 16,900 per µL

0

 

3,500 to 5,600 per µL

1

 

1,000 to 2,900 per µL

2

 

< 1,000 per µL

4

immature neutrophils

< 10%

0

 

>= 10%

2

lactic acid

< 4 mmol/L

0

 

>= 4 mmol/L

2

 

total score =

= SUM(points for all 8 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 28

• A score >= 6 was associated with ICU or telemetry unit admission, fetal tachycardia and positive blood cultures.

 

Performance:

• The AUC for the ROC curve for ICU admission wa 0.97.

• The cutoff >= 6 had a sensitivity of 89% and specificity of 95%.

 


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Specialty

Objective

ICD-10