Ressources et utilitaires

Scoring systems for ICU and surgical patients:

MSSS (Meningococcal Septic Shock Score)

Variables (help)	Values (1 if yes, 0 if no)	Beta	Points
Refractory hypotension
Base deficit > 10 mmol/L
Glasgow coma scale < 8	.
Leukocytes < 4000 / mm³	.
PTT > 150 % control	.
Cyanosis	.
Oliguria	.
(worst value during the first 2 h in the PICU is taken in account)		Predicted Death Rate: Logit = -5.623+ Sum (values*beta) Predicted Death Rate = e^(Logit) / (1 + e^(Logit))	Score: Score = Sum (points) Risk groups: L ow risk (score <=3) : Mortality rate 3% Intermediate risk (score 4-5) : Mortality rate 26% High risk (score >=6) : Mortality rate 74%

Reference

Castellanos-Ortega A et al. A new prognostic scoring system for meningococcal septic shock in children. Comparison with three other scores. Intensive Care Med 2002;28:341-351

Alpha value (-5.623) has not been still published (with courtesy of Alvaro Castellanos-Ortega).

Web page : Jean-Yves Marandon

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Definitions

Refractory hypotension
Presence of hypotension (SBP < 75 mmHg in children below the age of 4 years and < 85 mmHg in children older than 4 years) not normalized during the first 2h after admission despite adequat fluid resuscitation (volume load > 20 ml / kg) and treatment by dopamine or dobutamine > 5 µg/kg.min or by adrenaline or noradrenaline > 0.1 µg/kg.min.

Oliguria
Urine output < 1 mL/kg.h for at least one hour.

Cyanosis
Subjective variable.

Glasgow Coma Scale

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Eyes Open	Verbal	Motor
Spontaneous To speech To pain Absent	Converses / Oriented Converses / Disoriented Inappropriate Incomprehensible Absent	Obeys Localizes pain Withdraws (flexion) Decorticate (flexion) rigidity Decerebrate (extension) rigidity Absent