A prognostic score for systemic necrotizing vasculitis. It counts five adverse factors present at diagnosis. It measures prognosis, not disease activity. Choose the version that matches the diagnosis, then check each factor present.
| Factors Present | Category | Clinical Meaning |
|---|---|---|
| 0 | No Factors | No poor-prognosis factor present at diagnosis. Lowest risk stratum in the derivation cohort. |
| 1 | One Factor | Intermediate stratum. Mortality was higher than in the zero-factor group. Identify the factor present and address it directly. |
| 2 or more | Two or More | Highest-risk stratum. Mortality rose with each additional factor in the derivation cohorts. Warrants closer review of disease management and monitoring. The score does not specify a treatment regimen. |
The score is a prognostic guide. It does not replace assessment of organ involvement, disease activity (BVAS), or cumulative damage (VDI). Treatment decisions depend on the full clinical picture.
The original Five Factor Score was derived from a prospective French cohort of 342 patients with polyarteritis nodosa or Churg-Strauss syndrome (now EGPA). The 1996 version identified five adverse factors at diagnosis: proteinuria above 1 g/24 hours, creatinine above 140 µmol/L, cardiomyopathy, severe gastrointestinal involvement, and central nervous system involvement. Mortality increased with the number of factors present.
The 2011 revision by the French Vasculitis Study Group extended the analysis to GPA, MPA, PAN, and EGPA. It replaced proteinuria and CNS involvement with age over 65 and absence of ENT involvement (scored for GPA and EGPA only), and raised the creatinine threshold to 150 µmol/L.