Patients with a peripheral blood hematopoietic stem cell (PBSCT) or bone marrow transplant (BMT) tend to have a poor prognosis if they are admitted to the intensive care unit (ICU). Price et al developed a prognostic model for predicting mortality in these patients. This can help determine if intubation or other intervention is likely to benefit the patient. The authors are from MD Anderson Cancer Center in Houston.
Parameters identified in multiple logistic regression:
(1) intubation
(2) type of transplant
(3) infection
(4) respiratory rate
(5) days since transplant
(6) GI bleeding
(7) total bilirubin
(8) heart rate
Parameter |
Finding |
Points |
intubated |
no |
0 |
|
yes |
1 |
type of transplant |
non-allogenic |
0 |
|
allogenic |
1 |
infection |
absent |
0 |
|
probable |
1 |
respiratory rate in breaths/minute |
|
(respiratory rate) |
days since transplant |
|
(days) /100 |
GI bleeding |
absent |
0 |
|
present |
1 |
total bilirubin in mg/dL |
|
LN(bilirubin) |
heart rate in beats/minute |
|
(heart rate) |
X =
= (2.516 * (points for intubation)) + (1.525 * (points for transplant type)) + (4.412 * (points for infection)) + (0.088 * (points for respiratory rate)) + (0.635 * (points for days)) - (0.031 * ((points for days)^2)) + (3.177 * (points for GI bleeding)) + (0.884 * (points for bilirubin)) + (0.292 * (points for heart rate)) - (0.0013 * ((points for heart rate)^2)) – 25.501
probability of mortality =
= EXP(X) / (1 + EXP(X))
Specialty: Critical Care, Emergency Medicine, Hematology Oncology, Surgery, general
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