Thabut et al developed the IRISS (ischemia/reperfusion injury severity score) for evaluating lung transplant patients in the intensive care unit (ICU) with primary graft failure. This can help predict the probability of ICU death. The authors are from multiple lung transplant centers in France.
Parameters:
(1) ischemia time for the graft in hours
(2) age of the patient in years
(3) PaO2 to FIO2 ratio
(4) presence of severe early hemodynamic failure (EHF), defined as need for epinephrine or norepinephrine to maintain the mean systolic blood pressure > 60 mm Hg
|
Parameter |
Finding |
Points |
|
ischemia time in hours |
< 2 hours |
0 |
|
|
2 to 3.9 hours |
10 |
|
|
4 to 5.9 hours |
20 |
|
|
6 to 7.9 hours |
30 |
|
|
8 to 10 hours |
40 |
|
age of the patient in years |
< 30 years of age |
0 |
|
|
30 to 39 years |
9 |
|
|
40 to 49 years |
18 |
|
|
50 to 60 years |
27 |
|
|
> 60 years |
36 |
|
ratio of PaO2 to FIO2 |
> 250 |
0 |
|
|
200 to 250 |
16 |
|
|
150 to 199.99 |
32 |
|
|
100 to 149.99 |
48 |
|
|
50 to 99.99 |
64 |
|
|
< 50 |
80 |
|
severe EHF |
absent |
0 |
|
|
present |
18 |
where:
• A lung with an ischemia time > 10 hours was not scored.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum total: 0
• maximum total: 174
• The higher the score the greater the ICU mortality.
X =
= (0.0833 * (total score)) - 9.25
probability of ICU mortality =
= 1 / (1 + EXP((-1) * X))
Specialty: Critical Care, Emergency Medicine, Hematology Oncology, Surgery, general
ICD-10: ,
