Romano et al reported the Temperature, Neutrophil, Multiple Organ Failure (TNM score for evaluating a patient with acute cholecystitis. This is based on the TNM staging criteria in oncology. The authors are from University of L'Aquila in Italy.
Patient selection: acute cholecystitis
Parameters:
(1) temperature in °C
(2) percent neutrophils in the differential count
(3) number of organ failures
Parameter
Finding
Points
temperature
< 36.4°C
T4
36.4 to 37.4 °C
T0
37.5 to 38.4 °C
T1
38.5 to 39.0 °C
T2
39.1 to 39.5 °C
T3
> 39.5°C
T4
percent neutrophils
< 40%
N3
40 to 74%
N0
75 to 85%
N1
86 to 90%
N2
> 90%
N3
number of organ failures
0
M0
1
M1
2 or more
M2
TNM
Stage
Clinical Severity
T0 N0 M0
0
mild
T1 N0/N1 M0
Ia
mild
T2 N0/N1 M0
Ib
mild
T3 N0/N1/N2 M0
IIa
moderate
T4 N0/N1/N2 M0
IIb
moderate
any T, N3, M0
IIIa
severe
any T, any N, M1
IIIb
severe
any T, any N, M2
IV
sever with shock
Tazeoglu et al used the TNM staging system in patients with Fournier gangrene.
To read more or access our algorithms and calculators, please log in or register.
