Medical Scoring Systems

The CURB-65 score is a clinical prediction tool used to assess the severity of community-acquired pneumonia (CAP) in adults and guide decisions on treatment setting (outpatient, inpatient, or ICU). Developed in 2003 by Lim et al., it stratifies patients based on mortality risk using five simple criteria. The acronym stands for Confusion, Urea, Respiratory rate, Blood pressure, and age ≥65 years. CURB-65 is widely used in emergency departments, primary care, and hospital settings due to its simplicity and validated prognostic accuracy.

The Glasgow Coma Scale (GCS) is a standardized neurological assessment tool used to evaluate a patient’s level of consciousness after brain injury or in other critical conditions. Developed in 1974 by Graham Teasdale and Bryan Jennett at the University of Glasgow, it is widely applied across medical settings, including emergency departments, intensive care units (ICUs), and trauma centers, to assess patients of all ages, including adults, children, and infants (with pediatric modifications). The GCS quantifies consciousness through three components—eye opening, verbal response, and motor response—providing a reliable, objective measure for clinical decision-making, prognosis, and monitoring.

The SAPS II (Simplified Acute Physiology Score II) is a severity-of-illness scoring system designed for adult patients (aged ≥18 years) in intensive care units (ICUs). Developed in 1993 from a large multicenter study involving 13,152 patients across 137 ICUs in 12 countries, SAPS II predicts hospital mortality risk based on physiological, demographic, and clinical data collected within the first 24 hours of ICU admission. It is widely used for risk stratification, quality benchmarking, and research in adult critical care settings.

The SNAP-II (Score for Neonatal Acute Physiology II) and SNAPPE-II (Score for Neonatal Acute Physiology with Perinatal Extension II) are severity-of-illness scoring systems designed for neonates in neonatal intensive care units (NICUs). Developed in 2001 as simplified updates to the original SNAP scores, they quantify illness severity and predict mortality risk in newborns, particularly preterm or critically ill infants. SNAP-II focuses on physiological parameters, while SNAPPE-II extends SNAP-II by incorporating perinatal factors. These scores are widely used for risk adjustment, outcome prediction, and quality assessment in NICUs.

The PRISM (Pediatric Risk of Mortality) score is a validated severity-of-illness scoring system designed for pediatric patients (newborn to 18 years) in pediatric intensive care units (PICUs). Developed in 1988 and refined in subsequent iterations (PRISM III and PRISM IV), it quantifies disease severity and predicts hospital mortality risk based on physiological and laboratory data collected within the first 24 hours of PICU admission. PRISM is widely used to assess critically ill children, excluding premature neonates in neonatal ICUs (NICUs), where scores like CRIB II or SNAP-II are preferred.

The APACHE II (Acute Physiology and Chronic Health Evaluation II) score is a widely used severity-of-illness scoring system designed for adult patients in intensive care units (ICUs). Developed in 1985, it quantifies disease severity and predicts hospital mortality risk based on physiological measurements, age, and chronic health status. The score is calculated within the first 24 hours of ICU admission and is applicable across a broad range of adult critical care conditions. It is a cornerstone tool for risk stratification, quality assessment, and research in ICUs.

The CRIB II (Clinical Risk Index for Babies II) score is a validated risk-adjustment tool designed for use in neonatal intensive care units (NICUs) to predict mortality risk in preterm or very low birth weight (VLBW) newborns, specifically those born at <32 weeks gestation or weighing ≤1500 grams. It provides a standardized, objective method to assess illness severity and mortality risk within the first hour of NICU admission, aiding clinicians in risk stratification, quality assessment, and research.