May et al developed a score for predicting mortality based on findings on the basic metabolic profile (BMP). These can help to identify a patient who may benefit from more aggressive management. The authors are from the Intermountain Medical Center and University of Utah in Utah.
Patient selection: age >= 18 years of age
Results for a laboratory test were classified as low, normal or high based on the normal reference range. Exceptions were glucose (normal, intermedate or high, which ignores hypoglycemia), and creatinine (normal, intermediate, high and very high).
Parameters
(1) age in years
(2) gender
(3) serum sodium in mmol/L
(4) serum potassium in mmol/L
(5) serum bicarbonate in mmol/L
(6) serum calcium in mg/dL
(7) serum glucose in mg/dL
(8) serum creatinine in mg/dL
|
Parameter |
Finding |
Points for 30 Day |
Points for 1 Year |
Points for 5 Year |
|---|---|---|---|---|
|
age in years |
18 to 29 |
-2 |
-3 |
-3 |
|
|
30 to 39 |
-1 |
-1 |
-1 |
|
|
40 to 49 |
0 |
0 |
0 |
|
|
50 to 59 |
0 |
1 |
1 |
|
|
60 to 69 |
2 |
2 |
2 |
|
|
70 to 79 |
3 |
4 |
4 |
|
|
>= 80 |
5 |
7 |
9 |
|
gender |
female |
0 |
0 |
0 |
|
|
male |
0 |
1 |
1 |
|
serum sodium |
< 135 |
2 |
2 |
3 |
|
|
135 to 146 |
0 |
0 |
0 |
|
|
> 146 |
5 |
4 |
3 |
|
serum potassium |
< 3.5 |
1 |
1 |
1 |
|
|
3.5 to 5.3 |
0 |
0 |
0 |
|
|
> 5.3 |
2 |
2 |
2 |
|
serum bicarbonate |
< 20 |
4 |
2 |
1 |
|
|
20 to 32 |
0 |
0 |
0 |
|
|
> 32 |
3 |
3 |
4 |
|
serum calcium |
< 8.5 |
4 |
2 |
3 |
|
|
8.5 to 10.3 |
0 |
0 |
0 |
|
|
> 10.3 |
1 |
1 |
0 |
|
serum glucose |
< 100 |
0 |
0 |
0 |
|
|
100 to 125 |
1 |
1 |
1 |
|
|
> 125 |
3 |
2 |
2 |
|
serum creatinine |
< 0.8 |
1 |
1 |
1 |
|
|
0.8 to 1.19 |
0 |
0 |
0 |
|
|
1.2 to 1.99 |
2 |
1 |
1 |
|
|
>= 2.0 |
4 |
4 |
4 |
total score for each time frame =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score for 30-day mortality: -2
• maxiumum score for 30-day mortality: 27
• The cutoff for the 30-day score was >= 5.
• minimum score for 1 year mortality: -3
• maxiumum score for 1 year mortality: 25
• minimum score for 5 year mortality: -3
• maxiumum score for 5 yearmortality: 28
• The cutoff for the 1-year and 5-year score was >= 4.
|
Score |
30 Day |
1 Year |
5 Year |
|---|---|---|---|
|
-3 |
NA |
0.1% |
2% |
|
-2 |
0% |
0.2% |
5-6% |
|
-1 |
0% |
0.3% |
7% |
|
0 |
0% |
0.5% |
8-9% |
|
1 |
0.1% |
0.6% |
11-14% |
|
2 |
0.2% |
1% |
18-20% |
|
3 |
0.3% |
1.5% |
24-28% |
|
4 |
0.5% |
2.3% |
34% |
|
5 |
0.8% |
3.9% |
45% |
|
6 |
1.4% |
5.3% |
51-54% |
|
7 |
1.7% |
8% |
60% |
|
8 |
2.9% |
10% |
70% |
|
9 |
3.7% |
14-15% |
74% |
|
10 |
5% |
19% |
78% |
|
11 |
6% |
22% |
82% |
|
12 |
8-9% |
27-29% |
84-88% |
|
13 |
10-12% |
32-34% |
88% |
|
14 |
13-19% |
32-36% |
90% |
|
15 |
17-19% |
41% |
90% |
|
16 |
19% |
44-45% |
92-94% |
|
17 |
23-24% |
45-53% |
93-94% |
|
18 |
27-32% |
48% |
95% |
|
19 |
28% |
65-70% |
96% |
|
20 |
31-37% |
48-66% |
95% |
|
21 |
42% |
60-78% |
92-100% |
|
22 |
29-53% |
100% |
100% |
|
23 |
50% |
100% |
100% |
|
24 |
40-57% |
100% |
100% |
|
25 |
|
100% |
100% |
|
26 |
|
NA |
100% |
|
27 |
|
NA |
100% |
|
28 |
NA |
NA |
100% |
Purpose: To predict a patient's risk of death using the basic metabolic panel (BMP) score of May et al (Intermountain score).
Objective: risk factors, laboratory tests, severity, prognosis, stage
ICD-10: I46,
