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.
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