phoenix (version 1.1.1)

phoenix_neurologic: Phoenix Sepsis Neurological Score

Description

Assessment of neurologic dysfunction based on Glasgow Coma Scale (GCS) and pupil reactivity. This score is part of the diagnostic Phoenix Sepsis criteria and Phoenix 8 Sepsis criteria.

Usage

phoenix_neurologic(
  gcs = NA_integer_,
  fixed_pupils = NA_real_,
  data = parent.frame(),
  ...
)

Value

an integer vector with values 0, 1, or 2. As with all Phoenix organ dysfunction scores, missing input values map to scores of zero.

Arguments

gcs

integer vector; total Glasgow Comma Score

fixed_pupils

integer vector; 1 = bilaterally fixed pupil, 0 = otherwise

data

a list, data.frame, or environment containing the input vectors

...

pass through

Phoenix Neurological Scoring

Bilaterally fixed pupil	2 points
Glasgow Coma Score (total) less or equal 10	1 point
Reactive pupils and GCS > 10	0 point

Details

Missing values will map to a value of 0 as was done when developing the Phoenix criteria. Note that this is done on a input by input basis. That is, if pupil reactivity is missing but GCS (total) is 9, then the neurologic dysfunction score is 1.

GCS total is the sum of a score based on eyes, motor control, and verbal responsiveness.

Eye response:

1. no eye opening,

2. eye opening to pain,

3. eye opening to sound,

4. eyes open spontaneously.

Verbal response:

1. no verbal response,

2. incomprehensible sounds,

3. inappropriate words,

4. confused,

5. orientated

Motor response:

1. no motor response,

2. abnormal extension to pain,

3. abnormal flexion to pain,

4. withdrawal from pain,

5. localized pain,

6. obeys commands

References

See reference details in phoenix-package or by calling citation('phoenix').

See Also

• phoenix for generating the diagnostic Phoenix Sepsis score based on the four organ systems:

  • phoenix_cardiovascular,

  • phoenix_coagulation,

  • phoenix_neurologic,

  • phoenix_respiratory,

• phoenix8 for generating the diagnostic Phoenix 8 Sepsis criteria based on the four organ systems noted above and

  • phoenix_endocrine,

  • phoenix_immunologic,

  • phoenix_renal,

  • phoenix_hepatic,

vignette('phoenix') for more details and examples.

Examples

# using the example sepsis data set
phoenix_neurologic(
  gcs = gcs_total,
  fixed_pupils = as.integer(pupil == "both-fixed"),
  data = sepsis
)

# build an example data set with all possible neurologic scores
DF <- expand.grid(gcs = c(3:15, NA), pupils = c(0, 1, NA))
DF$target <- 0L
DF$target[DF$gcs <= 10] <- 1L
DF$target[DF$pupils == 1] <- 2L
DF$current <- phoenix_neurologic(gcs, pupils, DF)
stopifnot(identical(DF$target, DF$current))
DF