VALIDATION OF THE GLASGOW MENINGOCOCCAL SEPTICEMIA PROGNOSTIC SCORE - A 10-YEAR RETROSPECTIVE SURVEY

Objective: To derive performance characteristics for the Glasgow Meningococcal Septicemia Prognostic Score (GMSPS). Design: Retrospective case-note study. Setting: Two children's hospitals with Regional Intensive Care Unit. Patients: One hundred twenty-three children with proven meningococcal septicemia (some with concurrent meningitis) from January 1, 1977 to December 31, 1986. Measurements and Main Results: All 14 children who died after arrival scored greater-than-or-equal-to 8 either on admission (n = 8) or afterward (n = 6). Of 109 survivors, five scored greater-than-or-equal-to 8 (two were postictal at the time of scoring). A GMSPS of greater-than-or-equal-to 10 at or after admission predicted death with sensitivity 100%, specificity 98%, and positive predictive value of 88%; for GMSPS of both greater-than-or-equal-to 8 or 9, the values were 100%, 95%, and 74%, respectively. Conclusions: The GMSPS is a rapid clinical score that performs well in identifying children with poor prognosis who might benefit from early intensive care. It should be studied prospectively and compared with other scoring systems.