Description

Rieves et al developed equations to predict survival in a patient with severe COPD and acute respiratory failure. This can help identify patients who require more aggressive management and closer monitoring at the time of tracheal intubation. The authors are from the University of Mississippi in Jackson, Mississippi.


Patient selection: severe COPD with acute respiratory failure

 

Parameters at the time of tracheal intubation:

(1) pulmonary infiltrate on chest X-ray (0 if absent, 1 if present)

(2) serum albumin in g/dL

(3) FEV1 in liters

 

X =

= (-2.2211 * (albumin)) + (5.9265 * (points for pulmonary infiltrate)) + 3.6947

 

probability of nonsurvival =

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

 

Y =

= (-1.7851 * (points for pulmonary infiltrate) * (FEV1)) + (5.7065 * (points for pulmonary infiltrate)) - 2.5257

 

probability of nonsurvival =

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

 

Z =

= 5.7065 - (1.7851 * (FEV1))

 

mortality risk ratio (relative risk) for nonsurvival in those with

infiltrates relative to those without infiltrates =

= EXP(Z)


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