The SUPPORT Physiologic Score needs to be calculated before the prognosis for a patient in the Intensive Care Unit can be determined.
Data:
• All data is from day 3 after admission, except for albumin.
• The albumin data used is from day 1.
|
|
Primary |
Secondary |
Value |
|---|---|---|---|
|
1 |
acute renal failure or multiorgan failure present? |
|
259.9 |
|
2 |
COPD or CHF present? |
|
263.4 |
|
3 |
cirrhosis or coma present? |
|
241.4 |
|
4 |
lung or colon cancer present? |
|
281.5 |
|
5 |
PaO2/FIO2 |
PaO2/FIO2 < 225
PaO2/FIO2 >= 225 |
- 0.06174 * (PaO2/FIO2)
- 0.06174 * 225 |
|
6 |
blood pressure |
mean blood pressure < 60
mean blood pressure >= 60 |
-0.6316 * (mean BP)
-0.6316 * 60 |
|
7 |
WBC |
WBC <= 9 and ARF/MOSF present
WBC <= 9 and not ARF/MOSF
WBC > 9, < 40
WBC >= 40 |
1.0205 * WBC
1.0205 * 9
1.0205 * WBC
1.0205 * 40 |
|
8 |
WBC > 8 |
WBC <= 9 and ARF/MOSF present
WBC <= 9 and not ARF/MOSF
WBC > 9, < 40
WBC >= 40 |
-0.3676 * (WBC - 8)
-0.3676 * (9 - 8)
-0.3676 * (WBC - 8)
-0.3676 * (40 - 8) |
|
9 |
WBC > 11 |
WBC > 11, < 40
WBC >= 40 |
-0.5631 * (WBC - 11)
-0.5631 * (40 - 11) |
|
10 |
albumin |
albumin < 4.6
albumin >= 4.6 |
0.2691 * (albumin)
0.2691 * 4.6 |
|
11 |
apache III respiration score |
|
0.2312 * (score) |
|
12 |
temperature °C |
|
-2.362 * (temperature) |
|
13 |
temperature > 36.6 °C |
|
1.326 * ((temperature) - 36.6) |
|
14 |
temperature > 38.3 °C |
|
2.473 * ((temperature) - 38.3) |
|
15 |
heart rate |
|
-0.1579 * (heart rate) |
|
16 |
heart rate > 55 |
|
9.77 * 10^(-5) * (((heart rate) - 55)^3) |
|
17 |
heart rate > 80 |
|
-2.189 * 10^(-4) * (((heart rate) - 80)^3) |
|
18 |
heart rate > 110 |
|
1.518 * 10^(-4) * (((heart rate) - 110)^3) |
|
19 |
heart rate > 149 |
|
-3.062 * 10^(-5) * (((heart rate) - 149)^3) |
|
20 |
bilirubin |
|
0.9763 * (bilirubin) |
|
21 |
bilirubin > 7 |
|
- 0.7481 * ((bilirubin) - 7) |
|
22 |
creatinine |
creatinine <= 15
creatinine > 15 |
-6.8761 * (creatinine)
-6.8761 * 15 |
|
23 |
creatinine > 0.600 |
creatinine <= 15
creatinine > 15 |
11.6058 * (((creatinine) - 0.6) ^3)
11.6058 * (((15) - 0.6) ^3) |
|
24 |
creatinine > 1.000 |
creatinine <= 15
creatinine > 15 |
-21.8413 * (((creatinine) - 1.0) ^3)
-21.8413 * (((15) - 1.0) ^3) |
|
25 |
creatinine > 1.500 |
creatinine <= 15
creatinine > 15 |
10.3574 * (((creatinine) - 1.5) ^3)
10.3574 * (((15) - 1.5) ^3) |
|
26 |
creatinine > 5.399 |
creatinine <= 15
creatinine > 15 |
-0.1219 * (((creatinine) - 5.399) ^3)
-0.1219 * (((15) - 5.399) ^3) |
|
27 |
sodium |
|
-0.6167096 * (sodium) |
|
28 |
sodium > 128 |
|
0.0021118 * (((sodium) - 128) ^3) |
|
29 |
sodium > 135 |
|
-0.0036730 * (((sodium) - 135) ^3) |
|
30 |
sodium > 139 |
|
0.0006126 * (((sodium) - 139) ^3) |
|
31 |
sodium > 148 |
|
0.0009486 * (((sodium) - 148) ^3) |
|
32 |
COPD or CHF present |
albumin < 4.6
albumin >= 4.6 |
-6.278 * (albumin)
-6.278 * 4.6 |
|
33 |
lung or colon cancer present |
albumin < 4.6
albumin >= 4.6 |
-11.45 * (albumin)
-11.45 * 4.6 |
|
34 |
acute renal failure or multiorgan failure present |
WBC < 8
WBC >= 8, < 11
WBC >= 11, < 40
WBC >= 40 |
-2.3549 * (WBC)
-2.3549 * (WBC) + 2.7494 (WBC - 8)
-2.3549 * (WBC) + 2.7494 (WBC - 8) - 0.4638 * (WBC - 11)
-2.3549 * (40) + 2.7494 (40 - 8) - 0.4638 * (40 - 11) |
where:
• Definitions for acute renal failure, multi-organ failure, and the other clinical conditions are available in Murphy and Cluff (1990; Chapter 3, pages 11S-28S)
• The WBC value is set to 9 if the WBC count is < 9,000 and the patient does not have ARF or MOSF. The WBC value is set to 40 if the WBC count is > 40,000.
• The creatinine value is set to 15 if creatinine is > 15.
• The value to use for the "APACHE III respiration score" is not precisely defined but is assumed to be based on the following score from APACHE III based on the respiratory rate.
|
respiratory rate in breaths per minute |
Points |
|---|---|
|
<= 5 |
17 |
|
6 - 11 |
8 if not on mechanical ventilation; 0 if on mechanical ventilation |
|
12- 13 |
7 (0 points if rate 12 and patient on mechanical ventilation) |
|
14 - 24 |
0 |
|
25 - 34 |
6 |
|
35 - 39 |
9 |
|
40 - 49 |
11 |
|
>= 50 |
18 |
SUPPORT physiologic score =
= SUM (values from 34 elements listed above)
NOTE:
• The SUPPORT physiologic equation is copyrighted by George Washington University and cannot be used for commercial purposes without permission.
• This equation is fairly complex and confusing. Before using the spreadsheet, it is recommended that the assumptions and calculations be verified.
Specialty: Critical Care, Emergency Medicine
