da Hora Passos et al reported the HELENICC score to predict mortality for a septic patient with acute kidney injury. This can help to identify a patient who may require more aggressive management. The authors are from Hospital Portugues and Hospital Sao Rafael in Salvador, Brazil.
HELENICC is a word derived from letters in hepatic failure, lactate, norepinephrine, medical condition and creatinine.
Patient selection: sepsis, acute kidney injury on continuous renal replacement therapy (CRRT)
Outcome: 7-day mortality
Parameters:
(1) medical condition as reason for admission to the ICU (non-surgical)
(2) liver failure
(3) norepinephrine use
(4) serum lactate in mmol/L
(5) pre-dialysis serum creatinine in mg/dL
|
Parameter
|
Finding
|
Points
|
|
medical condition
|
no
|
0
|
|
|
yes
|
6
|
|
liver failure
|
no
|
0
|
|
|
yes
|
6
|
|
norepinephrine
|
no
|
0
|
|
|
yes
|
6
|
|
serum lactate
|
|
3 * (lactate)
|
|
serum creatinine
|
|
-2 * (creatinine)
|
where:
• Norepinephrine appears to be the pressor used. Therapy with other pressors probably would qualify.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: depends on lactate and creatinine values, could be negative
• maximum score: depends on lactate and creatinine values, over 20
• The higher the score the greater the risk of 7-day mortality.
|
Total Score
|
7-Day Mortality
|
|
< 8
|
7%
|
|
8 to 12
|
28%
|
|
13 to 20
|
57%
|
|
> 20
|
81%
|
Performance:
• The area under the ROC curve is 0.82.
