CART Model of de Rooij et al to Identify High Risk Subgroups of Very Elderly Patients in the Intensive Care Unit

Description

De Rooij et al evaluated very elderly patients admitted to the intensive care unit (ICU) using classification and regression tree (CART) analysis. They identified patients at risk for increased mortality. The authors are from the University of Amsterdam in The Netherlands.

Patient selection: >= 80 years of age

Parameters:

(1) Glasgow coma score (GCS)

(2) preceding event

(3) 24 hour urine output

(4) serum bicarbonate

(5) serum urea

(6) need for mechanical ventilation at 24 hours

(7) systolic blood pressure in mm Hg

(8) arterial pH

Parameter	A	B	C	D
GCS	>= 7	>= 7	>= 7	>= 7
preceding event	elective surgery	elective surgery	elective surgery	medical or urgent surgery
24 hour urine output	>= 1,250 mL	< 1,250 mL	< 1,250 mL	>= 750 mL
serum bicarbonate		>= 16.7 mmol/L	< 16.7 mmol/L
serum urea				>= 10.8 mmol/L
mechanical ventilation				no
systolic BP
arterial pH

Parameter	E	F	G	H
GCS	>= 7	>= 7	>= 7	>= 7
preceding event	medical or urgent surgery	medical or urgent surgery	medical or urgent surgery	medical or urgent surgery
24 hour urine output	>= 750 mL	>= 750 mL	>= 750 mL	< 750 mL
serum bicarbonate	>= 22.6 mmol/L	< 22.6 mmol/L
serum urea	>= 10.8 mmol/L	>= 10.8 mmol/L	< 10.8 mmol/L
mechanical ventilation	yes	yes
systolic BP				>= 72 mm Hg
arterial pH				>= 7.35

Parameter	I	J	K
GCS	>= 7	>= 7	< 7
preceding event	medical or urgent surgery	medical or urgent surgery
24 hour urine output	< 750 mL	< 750 mL
serum bicarbonate
serum urea
mechanical ventilation
systolic BP	>= 72 mm Hg	< 72 mm Hg
arterial pH	< 7.35

Group	Percent In-Hospital Mortality (Mean)
A	12%
B	26%
C	78%
D	33%
E	34%
F	57%
G	24%
H	29%
I	67%
J	88%
K	89%

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Description

Specialty

ICD-10