Medical Scores – S
SCORTEN SCORE FOR TEN PROGNOSIS:
- One point for each of: age ≥40, malignancy, body surface area detached ≥10%, tachycardia ≥120 bpm, serum urea >10 mmol/L, serum glucose >14 mmol/L, serum bicarbonate <20 mmol/L
- Used to determine appropriate clinical setting: score 0-1 can be treated in non-specialized wards; score ≥2 should be
- transferred to intensive care or burn unit
- Score at admission is predictive of survival: 94% for 0-1, 87% for 2, 53% for 3, 25% for 4, and 17% for ≥5
SEPSIS:
- Organ dysfunction defined as a change in baseline SOFA score ≥2 points.
- qSOFA score used initially to screen patients for suspected sepsis using three criteria:
-
- respiratory rate >22/min
- systolic BP <15)
- Altered mentation (GCS <15)
SOFA SCORE:
- >2 = 10% mortality risk in patient with suspected infection. Hospital mortality with septic shock >40%
QSOFA SCORE:
- respiratory rate >22/min
- systolic BP <100 mmHg
- altered mentation (GCS <15)
WORLD FEDERATION OF NEUROLOGICAL SURGEONS GRADING OF SAH:
| WFNS Grade | GCS Score | Aphasia, Hemiparesis, or Hemiplegia |
| 0 * | ||
| 1 | 15 | – |
| 2 | 13-14 | – |
| 3 | 13-14 | + |
| 4 | 7-12 | + or – |
| 5 | 3-6 | + or – |
*Intact aneurysm
SPETZLER-MARTIN AVM GRADING SCALE:
| Item | Score |
| Size | |
| 0-3 cm | 1 |
| 3.1-6.0 cm | 2 |
| >6 cm | 3 |
| Location | |
| Non eloquent | 0 |
| Eloquent | 1 |
| Deep Venous Drainage | |
| Not present | 0 |
| Present | 1 |
AVM grades calculated by adding the 3 individual Spetzler-Martin Scale scores from the above table.
e.g., a 2 cm tumour in non-eloquent location without deep venous drainage = Grade I
SPEECH DISCRIMINATION TEST:
- Patients with normal hearing or CHL score >90%
- Investigate further if scores dier more than 20% between ears, as asymmetry may indicate a retrocochlear lesion
- Best predictor of hearing aid response: a poor discrimination score indicates significant neural degeneration and hearing aids may not be the best option for the patient
M-CENTOR SCORE FOR PROBABILITY OF STREPTOCOCCAL PHARYNGITIS:
- For patients presenting with sore throat/pharyngitis and URTI symptoms:
-
- Must be older than 3 years old
- Cough — no Cough (+1)
- Exudates or swelling — tonsillar exudates/swelling (+1)
- Nodes — anterior Cervical adenopathy (+1) Temperature — hx of fever or Temperature >38 (+1)
- Only Young — patients <15yo (+1)
- Rarely Elder — Patients >45 (-1)
SEQUENTIAL (SEPSIS-RELATED) ORGAN FAILURE ASSESSMENT (SOFA) SCORE:
| Score | |||||
| System | 0 | 1 | 2 | 3 | 4 |
| Respiratory | |||||
| PaO2/FiO2, mmHg (kPa) | ≥400 (53.3) | <400 (53.3) | <300 (40) | <200 (26.7) with respiratory support | <100 (13.3) with respiratory support |
| Coagulation | |||||
| Platelets, x103/µL | ≥150 | <150 | <100 | <50 | <20 |
| Liver | |||||
| Bilirubin, µmol/L (mg/dL) | <20 (1.2) | 20-32 (1.2-1.9) | 33-101 (2.0-5.9) | 102-204 (6.0-11.9) | >204 (12.0) |
| Cardiovascular | MAP ≥70 mmHg | MAP <70 mmHg | Dopamine <5a
or Dobutamine (any dose) a |
Dopamine 5.1-15a
or epinephrine <0.1a or norepinephrine <0.1a |
Dopamine >15a or
Epinephrine >0.1a or Norepinephrine >0.1a |
| Central Nervous System | |||||
| Glasgow coma scale score | 15 | 13-14 | 10-12 | 6-9 | <6 |
| Renal | |||||
| Creatinine, µmol/L (mg/dL) | <110 (1.2) | 110-170 (1.2-1.9) | 171-299
(2.0-3.4) |
300-440 (3.5-4.9) | >440 (5.0) |
| Urine output, mL/d | <500 | <200 | |||
- Catecholamine doses are given as µg/kg/min for at least 1hr
- Table adapted from Singer et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315(8): 801-810.
THE AMERICAN COLLEGE OF RHEUMATOLOGY (ACR)/EUROPEAN LEAGUE AGAINST RHEUMATISM (EULAR)
- Criteria for Scleroderma*
| Item | Sub-item | Score |
| 1. Skin thickening of fingers of both hands extending proximal to the MCP (sufficient criterion) | 9 | |
| 2. Skin thickening of the fingers | Puffy fingers
Sclerodactyly |
2
4 |
| 3. Fingertip lesions | Digital tip ulcers
Fingertip pitting scars |
2
3 |
| 4. Telangiectasia | 2 | |
| 5. Abnormal nailfold capillaries | 2 | |
| 6. Pulmonary arterial HTN ± ILD (max score 2) | Pulmonary arterial HTN
ILD |
2
2 |
| 7. Raynaud’s phenomenon | 3 | |
| 8. Scleroderma related Ab | Anti-centromere
Anti-topoisomerase I Anti-RNA polymerase III |
3 |
* Score of ≥9 is sufficient to classify a patient as having definite scleroderma (sensitivity 0.95, specificity 0.93)
THE AMERICAN COLLEGE OF RHEUMATOLOGY (ACR)/EUROPEAN LEAGUE AGAINST RHEUMATISM (EULAR)
- CRITERIA FOR PRIMARY SJÖGREN’S SYNDROME (NO CONDITION IN EXCLUSION CRITERIA, SCORE ≥6):
| Criteria | Score | Comments |
| Labial salivary gland biopsy with focal lymphocytic sialadenitis with focus score ≥1 focus /4mm2 | 3 | Focus scores are histopathologic grading systems Strongly associated with phenotypic ocular and serological components of Sjögren’s |
| Anti-SSA or Ro positive | 3 | |
| Ocular staining score ≥5 (or van Bijsterfeld score ≥4 on at least one eye | 1 | Ocular staining score based on fluorescein dye examination of conjunctiva and cornea to determine clinical changes |
| Schirmer’s test ≤5 mm / 5 min on at least one eye | 1 | |
| Unstimulated whole saliva flow rate ≤0.1 mL/min | 1 |
Exclusion criteria include prior diagnosis of any of the following conditions:
1) history of head and neck radiation treatment, 2) active hepatitis C infection (with confirmation by polymerase chain reaction, 3) AIDS, 4) sarcoidosis, 5) amyloidosis, 6) graft-versushost disease, 7) IgG4-related disease.
