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Description

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.


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