Medical Scores – H
HEPARIN-INDUCED THROMBOCYTOPENIA (HIT):
- ESTIMATING THE PRE-TEST PROBABILITY OF HIT: THE “FOUR T’S”
| Points (0, 1, or 2 for Each of 4 Categories: Maximum Possible Score = 8) | |||
| 2 | 1 | 0 | |
| Thrombocytopenia | >50% Platelet fall to nadir >/= 20000 | 30–50% Platelet fall, or nadir 10000-19000 | <30% Platelet fall, or nadir <10000 |
| Timing* of onset of platelet fall (or other sequelae of HIT) | Days 5–10, or </= day 1 with recent heparin (past 30 days) | >Day 10 or timing unclear; or <day 1 with recent heparin
(Past 31–100 days) |
<Day 4 (no recent heparin) |
| Thrombosis or other sequelae | Proven new thrombosis; skin necrosis; or acute systemic reaction after intravenous UFH bolus | Progressive or recurrent thrombosis; erythematous skin lesions; suspected thrombosis (not proven) | None |
| Other cause(s) of platelet fall | None evident | Possible | Definite |
- UFH, Unfractionated heparin
- Pre-test probability score: 6–8 indicates high; 4–5, intermediate; and 0–3, low.
- *First day of immunizing heparin exposure considered day 0.
HYPERANDROGENISM:
- For Female:
-
- Ferriman-Gallwey scoring system is used to quantify severity of hirsutism (score of >8 is abnormal for white/black women, >9 abnormal for Mediterranean/Hispanic/Middle-Eastern women, >2 for Asian women)
GI HAEMORRHAGE SCORINGS:
| Risk stratification scores for Upper GI haemorrhage | |
| Blatchford score | Rockall score |
| • BUN
• Hb • BP • PR • H/o of Melena, Syncope, Liver or cardiac dysfunction |
• Age
• Comorbid diseases • Magnitude of haemorrhage (Based on BP and PR) • Transfusion requirement • Endoscopic findings** • Stigmata of recent bleed |
Medical Scores – I
REVISED ORIGINAL SCORING SYSTEM OF THE INTERNATIONAL AUTOIMMUNE HEPATITIS GROUP
| Category | Factor | Score |
| Gender | Female | +2 |
| AlkPhos: AST (or ALT) ratio | >3
<1.5 |
-2
+2 |
| Gamma-globulin or IgG (times
above upper limit of normal) |
>2.0
1.5-2.0 1.0-1.5 <1.0 |
+3
+2 +1 0 |
| ANA, SMA, or anti-LKM1 titers
|
>1:80
1:80 1:40 <1:40 |
+3
+2 +1 0 |
| AMA | Positive | -4 |
| Viral markers of active infection | Positive
Negative |
-3
+3 |
| Hepatotoxic drugs | Yes
No |
-4
+1 |
| Alcohol | <25 g/d
>60 g/d |
+2
-2 |
| Concurrent immune disease | Any non-hepatic disease of an immune nature | +2 |
| Other autoantibodies* | Anti-SLA/LP, actin, LC1, pANCA | +2
|
| Histologic features | Interface hepatitis
Plasma cells Rosettes None of above Biliary changes Atypical features |
+3
+1 +1 -5 -3 -3 |
| HLA | DR3 or DR4 | +1 |
| Treatment response | Remission alone
Remission with relapse |
+2
+3 |
| Pre-treatment score
Definite diagnosis Probable diagnosis Post-treatment score Definite diagnosis Probable diagnosis |
|
>15 10-15
>17 12-17 |
Abbreviations: Alkphos- serum alkaline phosphatase level; AST- serum aspartate
aminotransferase level; ALT- serum alanine aminotransferase level; IgG-serum
immunoglobulin G level; AMA- antimitochondrial antibodies; HLA- human leukocyte
antigen.
THE UNRUPTURED INTRACRANIAL ANEURYSM TREATMENT SCORE:
- Neurology 2015;85(10):881-9
-
- Objective: to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research.
- Methods: An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus method.
- Results: The UIATS accounts for 29 key factors in UIA management.
- Conclusions: This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty.
ICH SCORE COMPONENTS:
- GCS score (3-4 = 2 pts; 5-12=1 pt, 13-15=0 pt)
- ICH volume (≥30 cm= 1 pt, <30 cm= 0 pt)
- Presence of IVH (yes=1 pt, no=0 pt)
- Infratentorial origin (yes=1 pt, no=0 pt)
- Age (≥80 = 1 pt, <80 = 0 pt)
