Gastroenterologic Emergency Prognosis Equation - Medical Algorithm

Description

Niskanen et al developed 2 models based on logistic regression to predict in-hospital mortality for patients admitted to the intensive care unit (ICU) as a result of a gastroenterologic emergency. This can help identify patients who may benefit from more aggressive interventions. The authors are from 6 university hospitals in Finland.

Parameters	Model A	Model B
APS on day 1	0.164 * APS	0.143 * APS
TISS on day 1	0	0.041 * TISS
age in years	0.030 * age	0.030 * age
postoperative admission	add 0.076	add -0.097
liver disease present	add 0.944	add 0.938
cardiovascular disease present	add 0.559	add 0.672
respiratory disease present	add 0.416	add 0.441
renal disease present	add -0.216	add -0.104
immunocompromised state present	add 0.674	add 0.560
gastrointestinal bleeding present	add 0.364	add 0.423
sepsis present	add 0.690	add 0.555
neoplasm present	add 0.659	add 0.751
respiratory insufficiency after surgery	add -0.563	add -0.492
hemorrhagic shock present	add -0.292	add -0.470
bowel perforation or obstruction present	add -0.061	add -0.084
constant	-4.217	-5.088

where:

• The Acute Physiology Score (APS) was calculated from APACHE II.

A =

= SUM(items present in Model A)

B =

= SUM(items present in Model B)

probability for in-hospital death using Model A =

= 1 / (1 + EXP((-1) * A))

probability for in-hospital death using Model B =

= 1 / (1 + EXP((-1) * B))

Performance:

• The ROC plots show both models to be slightly better than APACHE II (Figure 3, page 591).

• The addition of TISS in Model B did not provide much benefit.

Limitations:

• The authors point out that the results of the calculations should be used with caution since the number of patients was too low to guarantee the accuracy for the outcome prediction.

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Description

Specialty

Objective

ICD-10

Predicting Patient Outcome Following an Gastroenterologic Emergency Using the Acute Physiology Score (APS) and TISS in the Equations of Niskanen et al

Purpose: To predict the in-hospital mortality for a patient admitted to the intensive care unit (ICU) following a gastroenterologic emergency.

Description

Specialty

Objective

ICD-10