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Mottling score predicts survival in septic shock
H Ait-Oufella1, S Lemoinne, P Y Boelle
1Service de Réanimation Médicale, Hôpital Saint-Antoine, Paris Cedex 12, France. hafid.aitoufella@sat.aphp.fr
Intensive Care Medicine
|March 5, 2011
Summary
The mottling score, a bedside assessment of skin discoloration, accurately predicts survival in patients with septic shock. A decreasing score during treatment indicates a better prognosis and improved survival rates.
Area of Science:
- Critical Care Medicine
- Microcirculation Research
- Sepsis Pathophysiology
Background:
- Microcirculation impairment is critical in severe infections like septic shock.
- Mottling, a visible sign of altered microcirculation, was investigated for its correlation with survival.
Purpose of the Study:
- To evaluate the prognostic value of the mottling score in patients with septic shock.
- To determine if mottling score variations during resuscitation predict survival.
Main Methods:
- A prospective observational study included consecutive septic shock patients over 7 months.
- The reproducible mottling score (0-5) was assessed, along with hemodynamic parameters.
- Predictive value of mottling score and variations on 14-day mortality was analyzed.
Main Results:
- Mottling score, oliguria, and arterial lactate levels strongly predicted 14-day mortality.
- Higher mottling scores correlated with earlier death.
- A decrease in mottling score during resuscitation significantly improved 14-day survival (12% vs. 77%).
Conclusions:
- The mottling score is a reproducible and easily applicable bedside tool.
- Both the mottling score and its change during resuscitation are powerful predictors of 14-day survival in septic shock.
