The 2026 consensus adaptation of the Popoveniuc system integrates thermoregulatory, neurological, cardiovascular, metabolic and precipitating features [12, 14]. The early-presentation score was 70, and the evolving-course score was 120. Later hypoxaemia, hypercarbia, hypoglycaemia, pulmonary oedema and the precipitating event were included only in the evolving-course calculation. The 2026 adaptation does not include the older ‘other ECG changes’ item and assigns 10 points to pulmonary oedema. Because the first documented BP was obtained during norepinephrine treatment, a sensitivity analysis excluded the 20 hypotension points; the corresponding scores were 50 (risk range, 45–59) and 100 (highly suggestive), respectively. BP: blood pressure; ECG: electrocardiogram; GCS: Glasgow Coma Scale; GFR: glomerular filtration rate; pCO2: partial pressure of carbon dioxide; SpO2: peripheral oxygen saturation.
Declarations
Acknowledgments
During the preparation of this work, the authors used ChatGPT (OpenAI) and Antigravity to assist with language refinement and editorial organisation. These tools were not used to make clinical decisions or determine the scientific conclusions. The authors independently reviewed and verified the clinical data, analyses, figure annotations, and references, edited the final text, and take full responsibility for the manuscript.
Author contributions
ABD: Conceptualization, Data curation, Writing—original draft, Writing—review & editing. HG: Data curation, Writing—review & editing. TE: Investigation, Writing—review & editing. SB: Investigation, Writing—review & editing. DK: Supervision, Writing—review & editing. All authors read and approved the submitted version.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Ethical approval
This case report was prepared in accordance with the Declaration of Helsinki. All clinical information was obtained during routine clinical care and was de-identified. Under the institutional policy applicable at Kocaeli City Hospital, formal ethics committee approval is not required for publication of a single anonymised case report.
Consent to participate
As the patient died during the admission, written informed consent to participate was obtained from the patient’s next of kin on his behalf.
Consent to publication
As the patient died during the admission, written informed consent for publication of the anonymised case details and images was obtained from the patient’s next of kin.
Availability of data and materials
The de-identified clinical, laboratory, electrocardiographic and imaging data supporting this case report are available from the corresponding author upon reasonable request, subject to institutional approval and patient-privacy restrictions.
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