Description

Kim et al report a score for helping to identify a patient admitted to a gastroenterology ward who needs to be transferred to the intensive care unit (ICU). The authors are from the University of Ulsan and Asan Medical Center in South Korea.


Patient selection: admitted to a gastroenterology service

 

Parameters:

(1) heart rate in beats per minute

(2) respiratory rate in breaths per minute

(3) ACDU score (alert, confused, drowsy, unresponsive)

(4) SpO2 to FIO2 ratio

(5) serum creatinine in mg/dL

(6) serum total bilirubin in mg/dL

(7) INR

(8) serum lactate in mmol/L

 

Parameter

Finding

Points

heart rate

< 105

0

 

>= 105

1

respiratory rate

< 26

0

 

>= 26

2

ACDU score

0

0

 

1 to 3

2

SpO2 to FIO2 ratio

>= 240

0

 

< 240

2

serum creatinine

< 2 mg/dL

0

 

>= 2.0 mg/dL

2

serum total bilirubin

< 9.0 mg/dL

0

 

>= 9.0 mg/dL

2

INR

< 1.5

0

 

>= 1.5

2

serum lactate

< 3.0 mmol/L

0

 

>= 3.0 mmol/L

2

 

where:

The ACDU score is mentioned in reference to the MEWS. Alert is scored 0 point and other 3 states from 1 to 3.

 

total score =

= SUM(points for all 8 paramters)

 

Interpretation:

minimum score: 0

maximum score: 15

A score >= 6 was associated with ICU admission and reduced survival.

 

Perforamnce:

The area under the ROC curve is 0.76.


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