The risk for developing seizures in Intensive Care Unit (ICU) patients with Gram-negative infections can be estimated using an additive predictive risk index.
Population:
(1) ICU patients with serious Gram-negative infections
(2) seizures were divided into early onset (within 48 hours of ICU admission) and late onset
Derivation of clinical risk score:
(1) factors identified by multiple logistic regression
(2) the weight assigned is based on rounding the regression coefficient to the nearest integer
History |
Factor |
Weight |
history before admission |
prior history of seizures |
2 |
|
any previous or current CNS tumors |
4 |
concurrent factors before onset of seizure |
acute stroke, intracranial hemorrhage, CNS surgery or CNS infection during or within 1 month before hospitalization |
3 |
|
coma or anoxic encephalopathy while in the ICU |
1 |
|
renal impairment (serum creatinine > 1.6 mg/dL, or dialysis) |
2 |
|
acute hypotensive episode while in the ICU |
1 |
clinical risk score =
= SUM(weights present)
Interpretation:
• minimum clinical risk score = 0
• maximum clinical risk score = 13
• clinical risk score <=2 indicates low risk for seizures
• clinical risk score >= 3 indicates a high risk for seizures
Specialty: Critical Care, Emergency Medicine, Neurology