Hypotension Prediction Score (HYPS) of Smischney et al for Post-Intubation Hypotension in a Critically-Ill Adult: Model for the Stable Cohort

Description

Smischney et al identified risk factors for hypotension following intubation in an adult in the intensive care unit (ICU). This can help to identify a high-risk patient who may require more aggressive management. The authors are from multiple institutions in the United States and members of the SCCM Discovery HEMAIR Investigators Consortium.

Patient selection: critically-illadult being intubated in stable condition

Items considered indicators that patient is unstable: sepsis, cardiac arrest, catecholamine therapy

Parameters:

(1) APACHE II score

(2) age in years

(3) intubation setting

(4) diuretics given in the past 24 hours

(5) phenylephrine given in the 60 minutes prior to intubation

(6) systolic blood pressure in mm Hg

Parameter	Finding	Points
APACHE II score	<= 10	0
	11 to 15	0.5
	16 to 20	1
	21 to 25	1.5
	>= 26	2
age in years	<= 40 years	0
	41 to 50	0.5
	51 to 60	1
	61 to 70	1.5
	71 to 80	2
	>= 81 years	3
intubation setting	respiratory failure	0
	MAP < 65 mm Hg	2
	other	0
diuretics	no	0
	yes	2.5
phenylephrine	no	0
	yes	0.5
systolic blood pressure	< 90 mm Hg	10.5
	90 to 99 mm Hg	7
	100 to 109 mm Hg	5
	110 to 119 mm Hg	3
	120 to 129 mm Hg	1
	>= 130 mm Hg	0

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 20.5

Total Score	Risk Group	Hypotension
<= 1.0	low	11%
1.5 to 11.5	moderate	28%
>= 12	high	67%

Performance:

• The area under the ROC curve is 0.71.

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Hypotension Prediction Score (HYPS) of Smischney et al for Post-Intubation Hypotension in a Critically-Ill Adult: Model for the Stable Cohort

Description

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