da Hora Passos et developed the HELENICC Score for predicting early (7-day) mortality in a patient with septic acute kidney injury (AKI) who requires continuous renal replacement therapy (CRRT). The authors are from Hospital Portugues and Hospital Sao Rafael in Salvador, Brazil.
HELENICC = HEpatic failure, LactatE, NorepInephrine, medical Condition, Creatinine
Patient selection: acute kidney injury associated with sepsis requiring continuous renal replacement therapy (CRRT)
Outcome: early mortality (within 7 days)
Parameters:
(1) medical condition as reason for admission to the ICU
(2) liver failure
(3) norepinephine or other vasopressor drug use
(4) serum lactate in mmol/L
(5) pre-dialysis serum creatinine adjusted for fluid load in mg/dL (equation of Moran and Myers)
|
Parameter
|
Finding
|
Points
|
|
medical condition
|
no
|
0
|
|
|
yes
|
6
|
|
liver failure
|
absent
|
0
|
|
|
present
|
6
|
|
norepinephrine
|
no
|
0
|
|
|
yes
|
6
|
|
serum lactate
|
|
3 * (serum lactate)
|
|
serum creatinine
|
|
(-2) * (creatinine)
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: varies with serum lactate and creatinine, negative values possible
• maximum score: varies with serum lactate and creatinine, probably around 25
• The higher the score the greater the 7-day mortality.
|
Score
|
7-Day Mortality
|
|
< 8
|
7%
|
|
8 to 12
|
28%
|
|
13 to 20
|
57%
|
|
> 20
|
81%
|
Performance:
• The area under the ROC curve was 0.82.
