Jentzer et al reported the Mayo CICU Admission Risk Score (M-CARS) for evaluating a patient admitted to the cardiac intensive care unit (CICU). The authors are from the Mayo CLinic and Brigham and Women's Hospital.
Patient selection: admission to the cardiac ICU
Parameters on admission:
(1) serum BUN in mg/dL
(2) anion gap
(3) Braden skin score
(4) RDW in percent
(5) diagnosis of cardiac arrest
(6) diagnosis of shock
(7) diagnosis of respiratory failure
Parameter |
Finding |
Points |
serum BUN |
<= 23 mg/dL |
0 |
|
> 23 mg/dL |
1 |
anion gap |
<= 14 |
0 |
|
> 14 |
1 |
Braden skin score |
<= 12 |
2 |
|
13 to 15 |
1 |
|
>= 16 |
0 |
RDW |
<= 14.3 |
0 |
|
> 14.3 |
1 |
cardiac arrest |
no |
0 |
|
yes |
2 |
shock |
no |
0 |
|
yes |
2 |
respiratory failure |
no |
0 |
|
yes |
1 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The odds ratio for in-hospital mortality is 1.84 for each point of increase.
• A M-CARS >= 2 with a day 1 SOFA >= 2 is associated with a mortality rate of 18%.
Score |
In-Hospital Mortality |
0 or 1 |
0.8% |
2 to 3 |
5 to 10% |
4 |
10-20% |
5 or 6 |
30% |
7 to 10 |
52% |
Performance:
• The area under the ROC curve is 0.86.
Specialty: Critical Care, Pulmonology