Cheng et al proposed a simple score for predicting mortality in a patient with meliodosis. This can help identify a patient who may require more aggressive management. The authors are from Menzies School of Health Research, Flinders University, and Royal Darwin Hospital in Australia.
Parameters present at the time of admission:
(1) presence or absence of pneumonia
(2) age in years
(3) serum bicarbonate in mmol/L
(4) serum urea in mmol/L
(5) serum creatinine in µmol/L (see note below table)
(6) serum total bilirubin in µmol/L
(7) absolute lymphocyte count
|
Parameter |
Finding |
Points |
|
pneumonia |
absent |
0 |
|
|
present |
1 |
|
age in years |
<= 50 years |
0 |
|
|
51 - 64 years |
1 |
|
|
>= 65 years |
2 |
|
serum bicarbonate |
>= 24.1 mmol/L |
0 |
|
|
16.1 - 24 mmol/L |
1 |
|
|
<= 16 mmol/L |
2 |
|
serum urea |
<= 8.0 mmol/L |
0 |
|
|
8.01 - 16.0 mmol/L |
1 |
|
|
>= 16.1 mmol/L |
2 |
|
serum total bilirubin |
<= 19 µmol/L |
0 |
|
|
20 - 33 µmol/L |
1 |
|
|
>= 34 µmol/L |
2 |
|
absolute lymphocyte count |
>= 1.3 * 10^9/L |
0 |
|
|
0.8 - 1.2 * 10^9/L |
1 |
|
|
<= 0.7 * 10^9/L |
2 |
where:
• Table 2 page 579 shows 2 points for serum creatinine when > 250 µmol/L. No other values are shown. The text on page 578 and Table 1 do not include creatinine in the multivariate model.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11 (according to Table 2; it would be 13 if serum creatinine is included)
• The higher the score the greater the risk of mortality.
|
Total Score |
Mortality Rate |
|
0 or 1 |
5% |
|
2 or 3 |
10% |
|
4 or 5 |
33% |
|
6 or 7 |
54% |
|
8 or 9 |
82% |
|
10 or 11 |
> 82% |
estimated from Figure 3, page 580
Specialty: Infectious Diseases
