Risk Factors of Szwarcberg et al for Identifying a Patient Who May Become Chronically Critically Ill

 

Criteria for a patient being classified as chronically critically ill - both of the following:

(1) ICU patient who is ventilator dependent

(2) tracheostomy performed electively because of a failure to wean

 

Patient selection: intubation for acute respiratory failure

 

Parameters:

(1) PaO2

(2) sepsis

(3) location prior to admission to the ICU

Parameter	Finding	Points
PaO2	normal or high	0
	low	1
sepsis	absent	0
	present	1
location before ICU	ER or PACU	1
	other	0

 

where:

• PACU = post anesthesia care unit

• The value for a low PaO2 was not stated. I will use <= 70 mm Hg on room air for the implementation (from the definition of the sepsis syndrome in 30.08.04).

 

total score =

= SUM(points all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The higher the score the higher the risk of undergoing tracheostomy. A patient with all 3 risk factors is 34 times more likely to undergo tracheostomy for failure to wean.