GCRBS scoring system for predicting outcome in severe falciparum malaria

Abstract

Background: Malaria is a protozoan disease caused by plasmodium species, transmitted by bite of infected female Anopheles mosquito, characterised by febrile paroxysms presenting with intermittent periodicity. It is diagnosed by Rapid antigen tests and blood smear tests. Severe malaria is almost exclusively caused by Plasmodium falciparum infection and can cause death within hours or days. Present study was done to give scoring system to predict the outcome in severe cases of falciparum malaria. Materials and Methods: This is a prospective study done on 100 patients diagnosed as severe falciparum malaria, admitted in the Department of General Medicine wards and Intensive Care Unit(ICU) of Kakatiya Medical College, Warangal, Telangana, India, between the period September 2015 to November 2017. GCRBS Scoring system was done on all patients using 5 parameters which includes GCS, Creatinine levels, Respiratory rate, Bilirubin levels and Systolic blood pressure. Results: The GCRBS score of 0-10 was given for all patients. The maximum score is 10 and least score is 0. Cutoff score was taken as 5. A score of >/= 5 was considered as having bad prognosis and score of < 5 was considered as having good prognosis. Our present study has a sensitivity of 86.95% and specificity of 94.8%. Conclusion: The GCRBS scoring system is simple and easy to calculate as 5 parameters are to be assessed to give a score. Hence it can be used as a bed side method to predict the outcome in severe falciparum malaria cases.