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MBRS Score of Fang et al for Evaluating a Cirrhotic Patient with Acute Renal Failure in the Intensive Care Unit

Purpose: To predict hospital mortality for a patient with cirrhosis and acute renal failure admitted to the ICU based on the study of Fang et al.

Description

Fang et al evaluated cirrhotic patients with acute renal failure (ARF) admitted to the intensive care unit (ICU). They correlated outcome with mean arterial pressure, serum total bilirubin, respiratory failure and sepsis in the MBRS score. The authors are from Chang Gung Memorial Hospital in Taipei, Taiwan.


Parameters:

(1) mean arterial blood pressure in mm Hg on admission

(2) serum total bilirubin in µmol/L on first day

(3) acute respiratory failure on first day

(4) sepsis on ICU admission

 

There are 2 ways to use the data:

(1) probability equation

(2) simple point score (= MBRS score)

 

X =

= (-0.061 * (mean arterial pressure)) + (0.007 * (serum bilirubin)) + (2.069 if respiratory failure present else 0) + (2.090 if sepsis present else 0) + 3.749

 

probability of death =

= 1 / (1 + EXP((-1) * X))

 

Parameter

Finding

Points

mean arterial pressure

> 80 mm Hg

0

 

<= 80 mm Hg

1

serum tota bilirubin

< 80 µmol/L (4.7 mg/dL)

0

 

>= 80 µmol/L

1

respiratory failure

absent

0

 

present

1

sepsis

absent

0

 

present

1

 

MBRS score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum MBRS score: 0

• maximum MBRS score: 4

• The higher the MBRS score the worse the prognosis.

 

MBRS Score

Hospital Mortality

0

33%

1

44%

2

91%

3 or 4

100%

 


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Specialty

Objective

ICD-10