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.