Shwachman Score

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Total score
Points
General activity
Physical examination
Nutrition
X ray findings

Excellent

(86-100)

25
normal
normal
normal
normal

Good

(71-85)

20
lack of endurance
rare cough, no clubbing, minimal hyperinflation
stools slightly abnormal
minimal accentuation of bronchovascular markings, early hyperinflation

Mild

(56-70)

15
tires easily after exertion
occasional cough wheeze, increased respiratory rate early clubbing
stools often abnormal, minimal abdo distension, reduced muscle mass
mild hyperinflation, patchy atelectasis, increases bronchoalveolar markings

Moderate

(41-55)

10
home teacher dyspnoea after short walk
frequent cough, clubbing, moderate hyperinflation crackles and wheezes
wt and ht below the 3rd centile, offensive stools, reduced muscle mass
moderate hyperinflation, widespread atelectasis and areas of infection

Severe

<40

5
orthopnoea stays in chair or bed
tachypnoea, tachycardia, extensive crackles, cyanosis, severe clubbing
marked malnutrition, rectal prolapse,etc
severe hyperinflation, lobar atelectasis and bronchiectasis. nodules/cysts, cardiac enlargement

Maximum score 100

Reference

Shwachman H, Kulczycki LL. Longterm study of one hundred and five patients with cystic fibrosis: studies made over a five to fourteen year period. Am J Dis Child 1958; 96: 6-15

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