Klein Klouwenberg et al reported a model for predicting onset of atrial fibrillation in a septic patient in the intensive care unit. The authors are from University Medical Center Utrecht and University of Amsterdam in The Netherlands.
Patient selection: septic adult in the intensive care unit (ICU)
Parameters in the past 24 hours
(1) age in years
(2) body mass index in kg per square meter
(3) immunocompromised state
(4) use of vasopressors or inotropes
(5) renal failure
(6) serum potassium in mmol/L (if more than 1 available, use the one furthest from 4.5 mmol/L
(7) serum potassium as spline function
(8) highest fraction of inspired air as a decimal fraction
(9) inflammation (see below)
(10) number of days in ICU (first day is scored 1)
|
Inflammation Markers
|
Degree
|
Points
|
|
CRP >= 150 mg/dL OR WBC>= 30,000 per µL
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severe
|
2
|
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CRP 70 to 149 mg/L OR WBC 15,000-29,999 per µl
|
moderate
|
1
|
|
CRP < 70 mg/dL AND WBC <= 15,000 per µL
|
none or mild
|
0
|
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
0.0522 * (age)
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|
BMI
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<= 30 kg per sq m
|
0
|
|
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> 30 kg per sq m
|
0.3076
|
|
immunocompromised
|
no
|
0
|
|
|
yes
|
0.3133
|
|
vasopressors or inotropes
|
no
|
0
|
|
|
yes
|
0.5901
|
|
renal failure
|
no
|
0
|
|
|
yes
|
0.4159
|
|
serum potassium
|
|
-0.2674 * (potassium)
|
|
serum potassium spline
|
|
value of spline function (below)
|
|
highest FIO2
|
|
0.8920 * (FIO2)
|
|
inflammation
|
severe
|
0. 7934 = 2 * 0.3967
|
|
|
moderate
|
0.3967
|
|
|
none or mild
|
0
|
|
number of days in ICU
|
|
-0.3571 * (number)
|
value of potassium spline function =
= (0.0821 * pmax(((potassium) - 3.2,0)^3)) - (0.1321 * pmax(((potassium) - 4.1,0)^3)) + (0.06091 * pmax(((potassium) - 5.3,0)^3))
value of X =
= SUM(points for all of the parameters) - 6.2252
risk of developing atrial fibrillation within 24 hours =
= 1 / (1 + EXP((-1) * X))
