Patient selection: adult admitted to ICU who has been intubated
Outcome: prolonged intubation (orotracheal intubation >= 7 days), indicating a patient who may benefit from early tracheostomy
Parameters:
(1) age in years (divided into tertiles)
(2) PaO2 to FiO2 ratio on intubation day
(3) serum sodium concentration on intubation day
(4) COPD
|
Parameter
|
Finding
|
Points
|
|
age
|
< 65 years old
|
1
|
|
|
65 to 76 years
|
2
|
|
|
>= 77 years
|
3
|
|
PaO2 ratio
|
>= 200
|
0
|
|
|
< 200
|
1
|
|
serum sodium
|
hypernatremia
|
1
|
|
|
other
|
0
|
|
COPD
|
absent
|
0
|
|
|
present
|
1
|
where:
• The adjusted odds ratios were 1.97 for age (per tertile), 3.9 for hypernatremia, 3 for COPD and 2.6 for PaO2 to FIO2 ratio.
X =
= (0.68 * (points for age)) + (0.97 * (points for PaO2 to FIO2 raio)) + (1.35 * (points for serum sodium)) + (1.1 * (points for COPD)) – 2.8
probability of requiring a tracheostomy =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.81.
