Scoring Based on Comprehensive Assessment and Criteria for Patients Requiring Inpatient Carea Among Adults With TBb
| Criteria | Considered to Be Emergencyc | Scoring Criteria | Score Assignedd |
|---|---|---|---|
| Pulse rate per minute | <60 | 2 | |
| >100 (persistent after 30 minutes) | 2 | ||
| BMI, kg/m2 | Yes (<14) | <14 | 1 |
| <16 with pedal edema | 1 | ||
| >40 | 1 | ||
| MUAC, cm | <16 | 1 | |
| Temperature, Celsius | Yes (<35, >41) | <35 | 2 |
| >41 | 2 | ||
| Blood pressure, mmHg | Yes | Hypertension (≥140/90) | 2 |
| Hypotension (diastolic <60) | 2 | ||
| Respiratory rate, breaths/minute | Yes (>24) | 18–24 | 1 |
| 25–30 | 2 | ||
| >30 | 3 | ||
| Oxygen saturation, % | Yes (<94) | 90–93 | 1 |
| 85–89 | 2 | ||
| <85 | 3 | ||
| Hemoglobin, g/dL | Yes (<7) | <7 | 2 |
| Icterus | Present | 1 | |
| Pedal edema | Present | 1 | |
| General condition | Yes (if unable to walk, drowsy, unconscious) | Inability to walk but conscious and oriented | 1 |
| Conscious, not oriented | 2 | ||
| Drowsy | 3 | ||
| HIV | Positive and on ART | 1 | |
| Positive and not on ART | 2 | ||
| Random blood sugar, mg/dL | <70 | 2 | |
| >200 | 2 | ||
| Total WBC count, WBC/microliter | Total count >11,000 | 1 | |
| Total count <4,000 | 1 | ||
| Chest radiograph | Yes (massive pneumothorax, hydropneumothorax) | Hydropneumothorax | 3 |
| Bilateral consolidation | 2 | ||
| Hemoptysis | Yes | Present | 3 |
Abbreviations: ART, antiretroviral therapy; BMI, body mass index; MUAC, mid-upper arm circumference; WBC, white blood cell.
↵a Modifications to the criteria provided by Central TB Division 2021 technical guidance5: blood sugar of >128 replaced with >200. In addition, inpatient care may be provided irrespective of the total score or presence/absence of emergency criteria if the treating physician feels the need for inpatient care.
↵b Based on Central TB Division 2021 Technical Guidance on Differentiated Care of TB Patients in India.5
↵c If there is an indicator suggesting emergency, the inpatient care should be provided irrespective of the total score.
↵d Patients with total score more than 1 to be provided inpatient care, and patients with total score more than 3 to be provided inpatient care in a facility with intensive care unit.