Mitsui and Kembo developed a clinical score for evaluating the severity of asthma. This can be used to monitor the response of the child to therapeutic interventions.
Patients:
(1) Mitsui and Kembo used the score in adult asthmatics.
(2) Obata et al used the score to evaluate young children < 5 years of age.
Parameters:
(1) dyspnea
(2) wheezes heard without stethoscope
(3) auscultation of rales
(4) speech impairment
(5) cyanosis
(6) mental status
|
Parameter |
Finding |
Points |
|
dyspnea |
none |
0 |
|
|
ability to be supine |
1 |
|
|
orthopnea |
2 |
|
wheezes |
none |
0 |
|
|
audible without stethoscope |
1 |
|
auscultation of rales |
none |
0 |
|
|
mild |
1 |
|
|
loud |
2 |
|
|
decreased |
3 |
|
|
absent |
3 |
|
speech impairment |
speech possible |
0 |
|
|
speech difficult or impossible |
1 |
|
cyanosis |
none |
0 |
|
|
present |
1 |
|
mental status |
normal |
0 |
|
|
agitated |
1 |
|
|
depressed |
1 |
|
|
coma |
2 |
clinical score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score, the more severe the episode.
|
Score |
Severity of Episode |
|
0 – 3 |
mild |
|
4 – 6 |
moderate |
|
7 - 10 |
severe |
Performance:
• The score shows good reproducibility.
• A high score correlated with hypoxemia, but a low score does not exclude hypoxemia.
• The score shows a good correlation with PaCO2.
Specialty: Pulmonology
