From the Guidelines
The Modified Marshall score is not explicitly defined in the provided evidence, but based on the context, it appears to be related to the Rotterdam score, which is a modified version of the Marshall score used to predict 6-month mortality in patients with traumatic brain injury. The Marshall score and its modifications, such as the Rotterdam score, are used to classify patients with traumatic brain injury based on noncontrast CT (NCCT) findings, including the presence of subarachnoid or intraventricular hemorrhage, effacement of the basilar cisterns, midline shift >5 mm, presence of subdural hemorrhage, and absence of epidural hemorrhage 1. The Rotterdam score is a well-standardized and validated tool that predicts 6-month mortality in patients with traumatic brain injury, and it is based on the combination of these NCCT findings 1. Key features of the Rotterdam score include:
- Presence of subarachnoid or intraventricular hemorrhage
- Effacement of the basilar cisterns
- Midline shift >5 mm
- Presence of subdural hemorrhage
- Absence of epidural hemorrhage These features are used to predict clinical outcomes, including 6-month mortality, in patients with traumatic brain injury 1. The Rotterdam score, as a modified version of the Marshall score, is a valuable tool in assessing the severity of traumatic brain injury and predicting patient outcomes.
From the Research
Definition of Modified Marshall Score
- The Modified Marshall Score is a severity score used to assess the severity of acute pancreatitis (AP) 2, 3, 4, 5.
- It is included in the Revised Atlanta Classification and is used to diagnose organ failure in severe acute pancreatitis 2.
Components of Modified Marshall Score
- The score assesses the severity of organ dysfunction, including respiratory, cardiovascular, and renal systems 3, 4.
- The renal component of the score utilizes a set serum creatinine level (sCr) to assess renal function 3.
Limitations of Modified Marshall Score
- The use of a fixed sCr value may misclassify stable patients with chronic kidney disease (CKD) as having more severe acute pancreatitis 3.
- Alternative scoring systems, such as the Revised Marshall Score, have been proposed to improve the accuracy of severity assessment 3.
Comparison with Other Scoring Systems
- The Modified Marshall Score has been compared with other scoring systems, including the Ranson criteria, APACHE-II score, and BISAP score 6, 4, 5.
- These studies have shown that the Modified Marshall Score is a useful tool for assessing the severity of acute pancreatitis, but may have limitations in certain patient populations 3, 6, 4, 5.