Modified Aldrete Scoring System

How is the Modified Aldrete score calculated?

The modified Aldrete score is measured by evaluating five criteria, including the individual’s activity level, respiration, circulation, consciousness, and oxygen saturation. A score of “0”, “1”, or “2” is given for each category, two representing the ideal condition.

1. The activity parameter is based on the ability to move extremities voluntarily or on command. A score of “2” is given for moving all four extremities, “1” for moving just two extremities, and “0” if the individual can’t move any of their extremities. 

2. For respiration, an individual is given two points when being able to breathe deeply and cough freely; one, if there’s a respiratory effort, but breathing is limited, or dyspnea is recognized, and a score of zero if they’re apneic. 

3. The circulation score is based on the systemic blood pressure values compared to the pre-anesthetic level. A score of “2”, “1”, or “0” is given for blood pressure that is less than 20%, 20-49%, or more than 49%, from the pre-anesthetic level.

4. Consciousness is a score of two for fully awake individuals, one for those arousable on calling, and zero for non-responsive patients. 

5. Scores are also given for the oxygen saturation value, and the method needed to achieve it. A score of two is given if an individual can maintain oxygen saturation of more than 92% on room air; a score of one is assigned if supplemental oxygen is required to maintain more than 90%; and finally, a score of zero is given if saturation is lower than 90% even with supplemental oxygen.

Finally, the scores from each index are summed up to a total score that determines the status of the individual and contributes to the decision for discharging the patient from the PACU.