Scoring Systems Flashcards
What is the Glasgow Coma Scale (GCS) score?
Scoring system used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients.
Three domains of calculating GCS.
- eye opening
- verbal response
- motor response
GCS scoring (eye opening):
4 (spontaneous)
3 (to sound)
2 (to pressure)
1 (none)
GCS scoring (verbal response):
5 (orientated)
4 (confused)
3 (words)
2 (sounds)
1 (none)
GCS scoring (motor response):
6 (obeys commands)
5 (localising)
4 (normal flexion)
3 (abnormal flexion)
2 (extension)
1 (none)
What is CURB-65 scoring?
Estimates mortality of community acquired pneumonia to help determine inpatient vs outpatient treatment.
CURB-65 score calculation:
Confusion (+1)
Urea >7mmol/L (+1)
Respiratory rate ≥ 30 (+1)
Blood pressure <90/60 (+1)
Age ≥ 65 (+1)
Score 0/1 = outpatient
Score 2 = inpatient
Score 3 = ITU
What is FeverPAIN scoring?
Predicts the likelihood of strep throat (and therefore need for antibiotics).
FeverPAIN score calculation:
Fever (+1)
Purulent tonsils (+1)
Absence of cough (+1)
Inflammation (+1)
New onset <3 days (+1)
If FeverPAIN ≥ 4 = antibiotics
What is CHA2DS2-VASc scoring?
Estimates stroke risk in patients with atrial fibrillation.
CHA2DS2-VASc score calculation:
Coronary heart failure (+1)
Hypertension (+1)
Age > 75 (+2)
Diabetes mellitus (+1)
Stroke / TIA (+2)
Vascular disease (+1)
Age > 65 (+1)
Sex (F) (+1)
If CHA2DS2-VASc ≥ 1 (M) consider anticoagulation.
If CHA2DS2-VASc ≥ 2 (F) consider anticoagulation.
Give the BTS guidelines for moderate acute asthma.
- PEFR 50-75% best or predicted
- no features of acute severe asthma
- increasing symptoms
Give the BTS guidelines for acute severe asthma.
- PEFR 33-49% best or predicted
- respiratory rate ≥ 25/min
- heart rate ≥ 110bpm
- inability to complete sentences in one breath
Give the BTS guidelines for life-threatening asthma.
- PEF <33%
- SpO2 < 92%
- PaO2 < 8kPa
- normal PaCO2
Clinical signs may include altered conscious level, exhaustion, arrhythmia, hypotension, cyanosis, silent chest or poor respiratory effort.
Give the BTS guidelines for near fatal asthma.
- raised PaCO2
What is MRC dyspnoea score?
Stratifies severity of dyspnoea in respiratory diseases, particularly COPD.
MRC dyspnoea score calculation:
0 - dyspnoea with strenuous exercise
1 - dyspnoea when walking up a slight hill
2 - dyspnoea meaning patient has to walk slower or stop for breath
3 - dyspnoea meaning patient has to stop for breath after walking for a few minutes
4 - too dyspnoeaic to leave house or breathless when dressing
Classification of CKD has two domains:
- ACR
- GFR
Give GFR categories description and ranges when scoring CKD.
G1 = ≥90 (normal / high)
G2 = 60-89 (mild reduction)
G3a = 45-59 (mild-moderate reduction)
G3b = 30-44 (moderate-severe reduction)
G4 = 15-29 (severe reduction)
G5 = <15 (kidney failure)
Note if in G1/A1 or G2/A1 there is no CKD.
Give ACR categories description and ranges when scoring CKD.
A1 = <3 (normal)
A2 = 3-30 (moderately increased)
A3 = >30 (severely increased)
Note if G1/A1 or G2/A1 there is no CKD.
MRC muscle power scale calculation:
5/5 = normal power
4/5 = active movement against gravity and resistance
3/5 = active movement against gravity
2/5 = active movement, with gravity eliminated
1/5 = flicker or trace of contraction
0/5 = no contration
What is ASA scoring system used for?
Classifies health of patients prior to surgery.
What is ORBIT (HAS-BLED) scoring system used for?
Estimates major bleeding risk for patients on anticoagulation, to assess risk-benefit in atrial fibrillation care.
What is Rockall scoring system used for?
Determines severity of GI bleeding, can only be determined within endoscopy.
What is POSSUM scoring system used for?
Estimates morbidity and mortality for general surgery patients.
What is NELA scoring system used for?
Risk calculation for estimate of death within 30 days of emergency abdominal surgery.
What is Ranson scoring system used for?
Estimates mortality of patients with pancreatitis, based on initial and 48-hour lab values.
What is ROME scoring system used for?
Estimates likelihood of irritable bowel syndrome as a diagnosis.
What is PHQ-9 scoring system used for?
Objectifies degree of depression severity.
What is GAD-7 scoring system used for?
Objectifies degree of anxiety severity.
What is FAST scoring system used for?
Predicts presence of pericardial or intra-abdominal injury after penetrating or blunt trauma.
What is GPCOG scoring system used for?
General Practitioner Assessment of Cognition score is designed as a GP screening tool for dementia.
What is STaRTBack scoring system used for?
Estimates risk of chronicity of back pain.
What is Epworth scoring system used for?
Estimates whether there is excessive daytime sleepiness that requires medical attention (e.g. sleep apnoea).
What is Berlin scoring system used for?
Provides diagnostic criteria for ARDS.
What is MUST scoring system used for?
Identifies patients who are malnourished or at risk of malnutrition.
What is QRISK scoring system used for?
Estimates 10-year probability of having a fatal coronary event (e.g. MI, stroke).
