Froom et al reported an index based primarily on laboratory findings that is predictive of mortality for a patient admitted acutely to the hospital. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals in Israel and Ireland.
Patient selection: acutely hospitalized patient
Parameters on admission:
(1) age in years
(2) WBC count in 10^9/L
(3) percent neutrophils in the differential count
(4) hemoglobin in g/dL
(5) MCV in fL
(6) platelet count in 10^9/L
(7) serum BUN in mg/dL
(8) serum creatinine in mg/dL
(9) serum sodium in mEq/L
(10) serum potassium in mEq/L
(11) serum glucose in mg/dL
(12) serum albumin in g/dL
(13) serum alkaline phosphatase in IU/L
(14) serum AST (SGOT) in U/L
(15) serum LDH in U/L
|
Parameter |
Finding |
Points |
|
age in years |
< 40 years |
0 |
|
|
40 to 59 years |
1 |
|
|
60 to 79 years |
2 |
|
|
>= 80 years |
3 |
|
WBC |
< 12 * 10^9/L |
0 |
|
|
12.01 to 14.9 * 10^9/L |
1 |
|
|
>= 15 * 10^9/L |
2 |
|
percent neutrophils |
<= 70 percent |
0 |
|
|
71 to 80 percent |
1 |
|
|
81 to 90 percent |
2 |
|
|
> 90 percent |
3 |
|
hemoglobin |
>= 12 g/dL |
0 |
|
|
10 to 11.9 g/dL |
1 |
|
|
< 10 g/dL |
2 |
|
MCV |
< 100 fL |
0 |
|
|
>= 100 fL |
1 |
|
platelet count |
>= 150 * 10^9/L |
0 |
|
|
100 to 149 *10^9/L |
1 |
|
|
< 100 * 10^9/L |
2 |
|
serum BUN |
< 20 mg/dL |
0 |
|
|
20 to 29 mg/dL |
1 |
|
|
>= 30 mg/dL |
2 |
|
serum creatinine |
< 2 mg/dL |
0 |
|
|
>= 2 mg/dL |
1 |
|
serum sodium |
< 148 mEq/L |
0 |
|
|
>= 148 mEq/L |
1 |
|
serum potassium |
< 3.5 mEq/L |
1 |
|
|
3.5 to 5.2 mEq/L |
0 |
|
|
>= 5.3 mEq/L |
1 |
|
serum glucose |
< 150 mg/dL |
0 |
|
|
150 to 199 mg/dL |
1 |
|
|
>= 200 mg/dL |
2 |
|
serum albumin |
>= 3.5 g/dL |
0 |
|
|
3.0 to 3.4 g/dL |
1 |
|
|
< 3.0 g/dL |
2 |
|
alkaline phosphatase |
<= 140 U/L |
0 |
|
|
141 to 199 U/L |
1 |
|
|
>= 200 U/L |
2 |
|
serum SGOT |
<= 40 U/L |
0 |
|
|
40.1 to 99.9 U/L |
1 |
|
|
>= 100 U/L |
2 |
|
serum LDH |
<= 400 U/L |
0 |
|
|
401 to 599 U/L |
1 |
|
|
>= 600 U/L |
2 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 42
• The higher the score the greater the mortality rate.
Performance:
• The area under the ROC curve is 0.86.
