Tam et al developed a nomogram for predicting the likelihood of unplanned admission to the intensive care unit (ICU). The authors are from Liverpool Hospital and the University of New South Wales in Sydney, Australia.
Patient selection: hospital admission, 10 to 110 years of age, ICU admission not planned for
Parameters:
(1) age in years
(2) gender
(3) admission from emergency department (ED)
(4) same-day admission
(5) maternity
(6) shift when admitted
(7) day of admission
(8) fractured femur
(9) acute pancreatitis
(10) liver disease
(11) chronic airways disease
(12) pneumonia
(13) heart failure
points for age =
= (0.755 * (age in years)) - 7.55
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
4.2 |
|
admission from ED |
no |
0 |
|
|
yes |
5.2 |
|
same day admission |
yes |
0 |
|
|
no |
100 |
|
maternity |
no |
0 |
|
|
yes |
33.5 |
|
shift when admitted |
night (midnight to 8 AM) |
0 |
|
|
day (8 AM to 4 PM) |
3 |
|
|
evening (4 PM to midnight) |
7.3 |
|
day of admission |
weekday |
0 |
|
|
weekend |
6.3 |
|
fractured femur |
no |
0 |
|
|
yes |
22.1 |
|
acute pancreatitis |
no |
0 |
|
|
yes |
32 |
|
liver disease |
no |
0 |
|
|
yes |
62.8 |
|
chronic airways disease |
no |
0 |
|
|
yes |
12.1 |
|
pneumonia |
no |
0 |
|
|
yes |
23.3 |
|
heart failure |
no |
0 |
|
|
yes |
3.6 |
where:
• Same-day admission and ED admission are treated as separate in the implementation although it might be possible to have both.
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 300
• The higher the score the greater the likelihood of unplanned ICU admission.
|
Score |
Percent with Unplanned ICU Admission |
|
0 to 181 |
< 1% |
|
181 to 220 |
(0.001373 * ((points)^2)) - (0.4755 * (points)) + 42.11 |
|
220 to 278 |
(0.004717 * ((points)^2)) - (1.989 * (points)) + 213.3 |
|
> 278 |
> 25% |
Specialty: Critical Care, Emergency Medicine
ICD-10: ,
