PLASMIC Score
Predicts probability of severe ADAMTS13 deficiency (TTP) in adults with thrombotic microangiopathy to guide urgent plasma exchange
Also written as: PLASMIC, Plasmic score, Plasmic.
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a detected disagreeing draft value is flagged for correction
- Care settings
- Emergency department, ICU, Inpatient
Calculate
Answer every item. The result uses the same scoring code Scribeable runs in notes. Nothing you enter leaves this page.
0 to 2000 x10^3/µL (= x10^9/L).
Hemolysis
Reticulocyte count above 2.5%, undetectable haptoglobin, or indirect bilirubin above 2 mg/dL.
Active cancer
Treated within the past year.
History of solid-organ or stem-cell transplant
40 to 160 fL.
0.5 to 20 INR.
0.1 to 30 mg/dL.
Enter the values above to see the result.
When it activates
Scribeable activates a calculator from the encounter. The PLASMIC Score can activate when the transcript or pasted chart context documents any of these:
- Suspected thrombotic thrombocytopenic purpura (TTP)
- Thrombotic microangiopathy workup
- Unexplained severe thrombocytopenia with hemolysis
- MAHA evaluation
- Decision for empiric plasma exchange
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: D69.3, M31.1.
Note-type scope: it activates on notes whose subject resolves to hospital medicine, critical care, emergency medicine. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
7 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Platelet count (x10^9/L) | lab | ×10⁹/L | Platelet count (×10⁹/L); PLASMIC point when <30. Asked as: “What is the platelet count (x10^9/L)?” |
| Evidence of hemolysis (reticulocytes >2.5%, haptoglobin undetectable, or indirect bilirubin >2.0 mg/dL) | lab | Schistocytes, elevated LDH, low haptoglobin, or elevated indirect bilirubin. Asked as: “Is there evidence of hemolysis (schistocytes, elevated LDH, low haptoglobin, or elevated indirect bilirubin)?” | |
| Active cancer treated within last year | history | Active cancer treated within the last year (PLASMIC scores a point when absent). Asked as: “Does the patient have active cancer treated within the last year?” | |
| History of solid organ or stem cell transplant | history | Prior solid organ or stem cell transplant (PLASMIC scores a point when absent). Asked as: “Has the patient had a prior solid organ or stem cell transplant?” | |
| Mean corpuscular volume (fL) | lab | fL | Mean corpuscular volume (fL); PLASMIC point when <90. Asked as: “What is the mean corpuscular volume (MCV, fL)?” |
| INR | lab | International normalized ratio; PLASMIC point when <1.5. Asked as: “What is the INR?” | |
| Serum creatinine (mg/dL) | lab | mg/dL | Serum creatinine (not urine). Asked as: “What is the serum creatinine (mg/dL)?” |
Scoring
7 binary criteria (1 point each): platelets <30, hemolysis present, no active cancer, no transplant history, MCV <90, INR <1.5, creatinine <2.0. Total 0-7.
Interpretation
0-4: Low risk (0-4% probability of TTP) — pursue alternative MAHA etiology. 5: Intermediate risk (~6%). 6-7: High risk (62-82% probability) — initiate empiric plasma exchange and steroids while awaiting ADAMTS13 activity. Does NOT apply when schistocytes are absent or no clinical concern for TMA.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Bendapudi PK et al. 2017.
- Bendapudi PK et al. Derivation and external validation of the PLASMIC score for rapid assessment of adults with thrombotic microangiopathiesBendapudi et al. (PLASMIC) 2017 · 2017 · Level II · link last verified 2026-04-14
How Scribeable handles it in the note
When an encounter activates the PLASMIC Score at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. If the draft states a PLASMIC Score value that disagrees with the computed one, the disagreement is flagged to the second drafting pass, which is instructed to correct the score and its interpretation before you see the note.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
See it activate on your own encounter
14 days of full Pro. No sales call.
14-day Pro trial, no credit card required. Everything in Pro, including Rounding, for up to 150 notes. To keep Pro after day 14, subscribe for $79/month plus applicable tax. If you don't, nothing is charged and your account becomes read-only, with every note kept.