medical decision support medical decision support
Sign In

Organ Dysfunctions and/or Infection (ODIN)

Purpose: To use the organ dysfunctions and/or infection (ODIN) model to predict the mortality of a patient in intensive care.

Description

The Organ Dysfunctions and/or Infection (ODIN) model assesses the number and type of organ dysfunctions in the intensive care patient. This information can be used to predict the patient's outcome.


Organ System

 

Finding

respiratory

 

PaO2 < 60 mm Hg on FIO2 0.21

 

OR

need for ventilatory support

cardiovascular (excluding patients showing hypovolemia, with CVP < 5 mm Hg)

 

systolic arterial pressure < 90 mm Hg with signs of peripheral hypoperfusion

 

OR

continuous infusion of vasopressor or inotropic agents required to maintain systolic pressure > 90 mm Hg

renal (excluding patients on chronic hemodialysis before hospital admission)

 

serum creatinine > 3.4 mg/dL (300 µmol/L)

 

OR

urine output < 500 mL in 24 hours or < 180 mL in 8 hours

 

OR

need for hemodialysis or peritoneal dialysis

neurologic

 

Glasgow coma scale <= 6 in the absence of sedation at any time during day

 

OR

sudden onset of confusion or psychosis

hepatic

 

serum bilirubin > 5.9 mg/dL (100 µmol/L)

 

OR

alkaline phosphatase > 3 times normal

hematologic

 

hematocrit <= 20 per cent

 

OR

white blood cell count < 2,000 per µL

 

OR

platelet count < 40,000 per µL

infection (with clinical evidence of infection)

 

2 or more positive blood cultures

 

OR

presence of gross pus in a closed space

 

OR

source of infection determined during hospitalization, or at autopsy in case of death within 24 hours

 

where:

• conversion for bilirubin from mg/dL to µmol/L is 17.1; reverse 0.0585

• conversion for creatinine from mg/dL to µmol/L is 88.4; reverse 0.0113

 

ODIN score =

= (1 if respiratory dysfunction present) + (1 if cardiovascular dysfunction present) + (1 if renal dysfunction present) + (1 if neurologic dysfunction present) + (1 if hepatic dysfunction present) + (1 if hematologic dysfunction present) + (1 if infection present)

 

Interpretation:

• maximum score = 7

• minimum score = 0

 

ODIN Score

Mortality

0

2.6%

1

9.7%

2

16.7%

3

32.3%

4

64.9%

5

75.9%

6

94.4%

7

100%

 

Logistic Regression Analysis

 

q =

= (-3.59) + (1.09 if respiratory dysfunction) + (1.19 if cardiovascular dysfunction) + (1.18 if renal dysfunction) + (0.86 if hematologic dysfunction) + (0.57 if hepatic dysfunction) + (0.99 if neurologic dysfunction) + (0.53 if infection present)

 

probability of death =

= (1 / (1 + EXP (-q)))


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10