Patient selection: patient with bleeding esophageal varices (presumably with cirrhosis)
Risk factors for ARDS:
(1) sepsis
(2) need for 2 or more sclerotherapy sessions to control bleeding
(3) hypoalbuminemia (<= 2.5 g/dL used in implementation, see Table 3)
(4) use of balloon tamponade
|
Parameter
|
Finding
|
Points
|
|
sepsis
|
absent
|
0
|
|
|
present
|
1
|
|
number of endoscopic treatments needed to control bleeding
|
0 or 1
|
0
|
|
|
2 or more
|
1
|
|
serum albumin
|
> 2.5 g/dL
|
0
|
|
|
<= 2.5 g/dL
|
1
|
|
balloon tamponade
|
no
|
0
|
|
|
yes
|
1
|
where:
• The need for multiple endoscopies to control bleeding and/or use of balloon tamponade suggests more severe bleeding. A patient may have repeat endoscopies to check for rebleeding but only active treatments should be counted.
• The coefficients for the logistic regression equation are given in Table 4 but not the constant.
total number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The risk of ARDS increases with the number of risk factors present.
