de Lange et al reported a score for predicting mortality in a patient in the intensive care unit (ICU) over 80 years of age. The authors are from multiple institutions in Europe.
Patient selection: critically-ill patient over 80 years of age
Outcome: 30-day mortality
Parameters:
(1) age in years
(2) gender
(3) reason for the admission
(4) SOFA score
(5) abbreviated clinical frailty score of Rockwood et al, from 1 to 7 (CSHA CFS)
(6) invasive mechanical ventilation
(7) renal replacement therapy (RRT)
(8) vasoactive drugs
|
Parameter |
Finding |
Points |
|
age |
< 83 years |
0 |
|
|
83 to 86.99 years |
1 |
|
|
>= 87 years |
2 |
|
gender |
female |
0 |
|
|
male |
1 |
|
reason for ICU admission |
intoxication |
0 |
|
|
emergency surgery or other |
3 |
|
|
respiratory failure, circulatory failure, sepsis, multi-trauma without head injury |
5 |
|
|
both respiratory and circulatory failure, isolated head injury |
6 |
|
|
multi-trauma with head injury or non-traumatic CNS cause |
7 |
|
SOFA score |
<3 |
0 |
|
|
3 to 5.99 |
1 |
|
|
6 to 7.99 |
3 |
|
|
8 to 10.99 |
4 |
|
|
>= 11 |
6 |
|
clinical frailty |
1 or 2 |
0 |
|
|
3 |
1 |
|
|
4 or 5 |
2 |
|
|
6 |
3 |
|
|
7 |
5 |
|
mechanical ventilation |
no |
0 |
|
|
yes |
3 |
|
renal replacement |
no |
0 |
|
|
yes |
2 |
|
vasoactive drugs |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 27 (the paper says 26)
• A score > 10 identified 92% of patients who died in 30 days (sensitivity). According to Figure 1 the specificity was around 38%.
Performance:
• The area under the ROC curve is 0.80.
Specialty: Critical Care
