The Sequential Clinical Assessment of Respiratory Function (SCARF) score is a dynamic pulmonary physiologic tool designed to predict adverse outcomes in critically ill patients with rib fractures. It incorporates four bedside variables: percent predicted inspiratory capacity less than 50%, respiratory rate over 20, numeric pain score 5 or higher, and inadequate cough, with each factor contributing one point. The score ranges from 0-4 and can be assessed on admission and sequentially during ICU stay. Higher admission, peak, and rising SCARF scores are associated with increased risk of pneumonia, high oxygen requirements, and prolonged ICU stay. A score greater than 2 may indicate the need for escalated pain management and respiratory support.
Reference
Kimberly S Hardin, Kiara N Leasia, James Haenel et al. The Sequential Clinical Assessment of Respiratory Function (SCARF) score: A dynamic pulmonary physiologic score that predicts adverse outcomes in critically ill rib fracture patients. J Trauma Acute Care Surg. 2019 Dec;87(6):1260-1268.
Open reference URL