Index of Ouchi et al for Predicting In-Hospital Mortality for an Older Adult Without Trauma Intubated in the Emergency Department

Description

Ouchi et al reported a score for predicting in-hospital mortality for an older adult intubated in the Emergency Department (ED) with conditions other than trauma. These can help to identify patients who may benefit from more aggressive management. The authors are from Briham and Women's Hospital, Harvard Medical School, Ariadne Labs (Boston), Vizient (Irving, Texas), Dana-Farber Cancer Center and Beth Israel Deaconess Medical Center.

Patient selection: adult >= 75 years, intubated in ED

Exclusions: trauma, out-of-hospital cardiac arrest

Outcome: in-hospital mortality

Parameters:

(1) comorbid condition (myocardial infarction, cerebrovascular diseaes, metastatic cancer)

(2) age in years

(3) admission diagnosis (sepsis, stroke or intracranial hemorrhage)

Parameter	Finding	Points
myocardial infarction	absent	0
	present	1.2
cerebrovascular disease	absent	0
	present	1.4
metastatic cancer	absent	0
	present	4
age	75 to 79 years	0
	80 to 84 years	1
	85 to 89 years	1.7
	>= 90 years	2.6
admission diagnosis	sepsis	1.9
	stroke or intracranial hemorrhage as admission diagnosis	3.1
	neither	0

Interpretation:

• minimum score: 0

• maximum score: 12.3

• The higher the score the worse the prognosis.

Score	Risk Group	In-Hospital Mortality
0 to 5.9	low	31%
6 to 10	medium	40%
> 10	high	59%

Performance:

• The stated risk for in-hospital mortality for the high-risk group is less than expected.

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