Bains and Soni developed a simple score (TOPRS) for evaluating a sick child in the emergency department. This can help to identify a patient who may benefit from more aggressive management. The authors are from Dayanand Medical College in Ludhiana, India.
Patient selection: pediatric patients coming to the emergency department (ages not given)
|
Parameter |
Normal (Points = 0) |
Abnormal (Points = 1) |
|
Temperature (T) |
36 to 38 degrees C |
< 36, > 38 |
|
Oxygen saturation (O) |
>= 90% |
< 90% |
|
Pulse (P) in beats per minute |
infant < =160, child <= 150 |
infant > 160, child >150 |
|
Respiratory rate (R) in breaths per minute |
infant <= 60, child <= 50 |
infant > 60, child > 50 |
|
Sensorium (S) |
normal consciousness |
impaired consciousness |
|
Seizures (S) |
no |
yes |
TOPRS =
= (0.75 * (points for temperature)) + (2.6 * (points for oxygen saturation)) + (0.41 * (points for pulse)) + (1.84 * (points for respiratory rate)) + (1.16 * (points for sensorium)) – (0.08 * (points for seizures))
Interpretation:
• minimum score: - 0.08
• maximum score: 6.68
• The higher the score the worse the survival.
|
Total Score |
Mortality Rate |
|
0 |
4.4% |
|
1 |
12.5% |
|
2 |
38% |
|
3 |
60% |
|
4 |
67% |
|
5 |
80% |
|
6 |
100% |
When analyzed this data can be represented as
|
Total Score |
Mortality Rate |
|
0 to 3 |
(3.475 * ((score)^2)) + (8.805 * (score)) + 3.355 |
|
3 to 6 |
(3.25 * ((score)^2)) - (15.95 * (score)) + 78.65 |
Performance:
• The area under ROC curve was 84%.
• The mortality was 127 out of 777 children which may reflect an underserved population.
Specialty: Pedatrics
ICD-10: ,
