/* file: saps_score.c G. Moody 22 March 2012
Calculate SAPS-I score given data from a Challenge 2012 record
*/
#define PLEN 16 /* max length of data type string, including trailing zero */
struct data {
int time; /* minutes since admission */
char p[PLEN]; /* type of data */
double val; /* parameter value */
};
typedef struct data Data;
#define MISSING (-2)
#define INVALID (-1)
int score_age(double age)
{
if (age > 200) return INVALID;
else if (age > 75) return 4;
else if (age > 65) return 3;
else if (age > 55) return 2;
else if (age > 45) return 1;
else if (age >= 0) return 0;
else return MISSING;
}
int score_hr(double hr)
{
if (hr > 250) return INVALID;
else if (hr >= 180) return 4;
else if (hr >= 140) return 3;
else if (hr >= 110) return 2;
else if (hr >= 70) return 0;
else if (hr >= 55) return 2;
else if (hr >= 40) return 3;
else if (hr >= 10) return 4;
else if (hr >= 0) return INVALID;
else return MISSING;
}
int score_sbp(double sbp)
{
if (sbp > 300) return INVALID;
else if (sbp >= 190) return 4;
else if (sbp >= 150) return 2;
else if (sbp >= 80) return 0;
else if (sbp >= 55) return 2;
else if (sbp >= 20) return 4;
else if (sbp >= 0) return INVALID;
else return MISSING;
}
int score_temp(double temp)
{
if (temp > 45) return INVALID;
else if (temp >= 41) return 4;
else if (temp >= 39) return 3;
else if (temp >= 38.5) return 2;
else if (temp >= 36) return 0;
else if (temp >= 34) return 1;
else if (temp >= 32) return 2;
else if (temp >= 30) return 3;
else if (temp >= 15) return 4;
else if (temp >= 0) return INVALID;
else return MISSING;
}
int score_resp(double resp)
{
if (resp > 80) return INVALID;
else if (resp >= 50) return 4;
else if (resp >= 35) return 3;
else if (resp >= 25) return 1;
else if (resp >= 12) return 0;
else if (resp >= 10) return 1;
else if (resp >= 6) return 2;
else if (resp >= 2) return 4;
else if (resp >= 0) return INVALID;
else return MISSING;
}
int score_ur(double ur)
{
if (ur > 20.0) return INVALID;
else if (ur >= 5.0) return 2;
else if (ur >= 3.5) return 1;
else if (ur >= 0.7) return 0;
else if (ur >= 0.5) return 2;
else if (ur >= 0.2) return 3;
else if (ur >= 0) return 4;
else return MISSING;
}
int score_bun(double bun)
{
if (bun > 100) return INVALID;
else if (bun >= 55) return 4;
else if (bun >= 36) return 3;
else if (bun >= 29) return 2;
else if (bun >= 7.5) return 1;
else if (bun >= 3.5) return 0;
else if (bun >= 1) return 1;
else if (bun >= 0) return INVALID;
else return MISSING;
}
int score_hct(double hct)
{
if (hct > 80) return INVALID;
else if (hct >= 60) return 4;
else if (hct >= 50) return 2;
else if (hct >= 46) return 1;
else if (hct >= 30) return 0;
else if (hct >= 20) return 2;
else if (hct >= 5) return 4;
else if (hct >= 0) return INVALID;
else return MISSING;
}
int score_wbc(double wbc)
{
if (wbc > 200) return INVALID;
else if (wbc >= 40) return 4;
else if (wbc >= 20) return 2;
else if (wbc >= 15) return 1;
else if (wbc >= 3) return 0;
else if (wbc >= 1) return 2;
else if (wbc >=0.1) return 4;
else if (wbc >= 0) return INVALID;
else return MISSING;
}
int score_glu(double glu)
{
if (glu > 1000) return INVALID;
else if (glu >= 44.5) return 4;
else if (glu >= 27.8) return 3;
else if (glu >= 14.0) return 1;
else if (glu >= 3.9) return 0;
else if (glu >= 2.8) return 2;
else if (glu >= 1.6) return 3;
else if (glu >= 0.5) return 4;
else if (glu >= 0) return INVALID;
else return MISSING;
}
int score_k(double k)
{
if (k > 20) return INVALID;
else if (k >= 7.0) return 4;
else if (k >= 6.0) return 3;
else if (k >= 5.5) return 2;
else if (k >= 3.5) return 0;
else if (k >= 3.0) return 1;
else if (k >= 2.5) return 2;
else if (k >= 0.5) return 4;
else if (k >= 0) return INVALID;
else return MISSING;
}
int score_na(double na)
{
if (na > 200) return INVALID;
else if (na >= 180) return 4;
else if (na >= 161) return 3;
else if (na >= 156) return 2;
else if (na >= 151) return 1;
else if (na >= 130) return 0;
else if (na >= 120) return 2;
else if (na >= 110) return 3;
else if (na >= 50) return 4;
else if (na >= 0) return INVALID;
else return MISSING;
}
int score_hco3(double hco3)
{
if (hco3 > 100) return INVALID;
else if (hco3 >= 40) return 4;
else if (hco3 >= 30) return 1;
else if (hco3 >= 20) return 0;
else if (hco3 >= 10) return 1;
else if (hco3 >= 5) return 2;
else if (hco3 >= 2) return 4;
else if (hco3 >= 0) return INVALID;
else return MISSING;
}
int score_gcs(double gcs)
{
if (gcs > 15) return INVALID;
else if (gcs >= 13) return 0;
else if (gcs >= 10) return 1;
else if (gcs >= 7) return 2;
else if (gcs >= 4) return 3;
else if (gcs >= 3) return 4;
else if (gcs >= 0) return INVALID;
else return MISSING;
}
int saps_score(Data *d, int n)
{
int s_age, s_hr, s_sbp, s_temp, s_resp, s_ur, s_bun, s_hct,
s_wbc, s_glu, s_k, s_na, s_hco3, s_gcs;
int i, s, saps, missing = 0;
double urine_tot = 0.;
s_age = s_hr = s_sbp = s_temp = s_resp = s_ur = s_bun = s_hct =
s_wbc = s_glu = s_k = s_na = s_hco3 = s_gcs = MISSING;
/* examine data from the first 24 hours only */
for (i = 0; i < n && d->time <= 24*60; i++, d++) {
if (strcmp(d->p, "Age") == 0) {
if ((s = score_age(d->val)) > s_age) s_age = s; }
else if (strcmp(d->p, "HR") == 0) {
if ((s = score_hr(d->val)) > s_hr) s_hr = s; }
else if (strcmp(d->p, "SysABP") == 0 || strcmp(d->p, "NISysABP") == 0) {
if ((s = score_sbp(d->val)) > s_sbp) s_sbp = s; }
else if (strcmp(d->p, "Temp") == 0) {
if ((s = score_temp(d->val)) > s_temp) s_temp = s; }
else if (strcmp(d->p, "RespRate") == 0) {
if ((s = score_resp(d->val)) > s_resp) s_resp = s; }
else if (strcmp(d->p, "MechVent") == 0) {
if ((s = score_resp(49.0)) > s_resp) s_resp = s; }
else if (strcmp(d->p, "Urine") == 0)
urine_tot += d->val;
else if (strcmp(d->p, "BUN") == 0) {
if ((s = score_bun(d->val/2.8)) > s_bun) s_bun = s; }
else if (strcmp(d->p, "HCT") == 0) {
if ((s = score_hct(d->val)) > s_hct) s_hct = s; }
else if (strcmp(d->p, "WBC") == 0) {
if ((s = score_wbc(d->val)) > s_wbc) s_wbc = s; }
else if (strcmp(d->p, "Glucose") == 0) {
if ((s = score_glu(d->val/18.0)) > s_glu) s_glu = s; }
else if (strcmp(d->p, "K") == 0) {
if ((s = score_k(d->val)) > s_k) s_k = s; }
else if (strcmp(d->p, "Na") == 0) {
if ((s = score_na(d->val)) > s_na) s_na = s; }
else if (strcmp(d->p, "HCO3") == 0) {
if ((s = score_hco3(d->val)) > s_hco3) s_hco3 = s; }
else if (strcmp(d->p, "GCS") == 0) {
if ((s = score_gcs(d->val)) > s_gcs) s_gcs = s; }
}
/* s_ur is determined by total urine output over 24 hours */
s_ur = score_ur(urine_tot/1000.0);
/* Sum the SAPS components. */
if (s_age >= 0) saps = s_age; else missing++;
if (s_hr >= 0) saps += s_hr; else missing++;
if (s_sbp >= 0) saps += s_sbp; else missing++;
if (s_temp >= 0) saps += s_temp; else missing++;
if (s_resp >= 0) saps += s_resp; else missing++;
if (s_ur >= 0) saps += s_ur; else missing++;
if (s_bun >= 0) saps += s_bun; else missing++;
if (s_hct >= 0) saps += s_hct; else missing++;
if (s_wbc >= 0) saps += s_wbc; else missing++;
if (s_glu >= 0) saps += s_glu; else missing++;
if (s_k >= 0) saps += s_k; else missing++;
if (s_na >= 0) saps += s_na; else missing++;
if (s_hco3 >= 0) saps += s_hco3; else missing++;
if (s_gcs >= 0) saps += s_gcs; else missing++;
if (missing == 0) return (saps);
else return (-saps); /* return partial scores as negative */
}