What is the Westley score for assessing severity of croup?

Updated: Oct 09, 2019
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Croup scores have been developed to assist the clinician in assessing the patient's degree of respiratory compromise. A commonly cited croup severity rating score is called the Westley score. Although widely used for research purposes and for the evaluation of treatment protocols, its clinical application has not been extensively studied. The Westley score evaluates the severity of croup by assessing five factors: level of consciousness, cyanosis, stridor, air entry, and retractions. The point values given for each factor are listed below, and the final score sum has a range of 0 to 17.

  • Level of consciousness: Normal, including sleep - 0 points, Depressed - 5 points

  • Cyanosis: None - 0 points, Upon agitation - 4 points, At rest - 5 points

  • Inspiratory stridor: None - 0 points, Upon agitation - 1 point, At rest - 2 points

  • Air entry: Normal - 0 points, Mild decrease - 1 point, Marked decrease - 2 points

  • Retractions: None - 0 points, Mild - 1 point, Moderate - 2 points, Severe - 3 points

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