Hatchimonji et al reported a pilot study using a score for long-term surgical patients in the intensive care unit (ICU). This can help to identify a patient who has a high risk of eventual mortality. The authors are from the University of Pennsylvania.
Patient selection: long-term surgical patient in the ICU
Parameters:
(1) Glasgow coma scale (GCS)
(2) serum total bilirubin in mg/dL
(3) renal replacement therapy (RRT) duration in days
(4) palliative care consult in the first 14 days
|
Parameter
|
Finding
|
Points
|
|
GCS
|
|
45 - (3 * (GCS))
|
|
serum total bilirubin
|
|
|
|
RRT duration
|
< 3 days
|
0
|
|
|
>= 3 days
|
18
|
|
palliative care consult
|
no
|
0
|
|
|
yes
|
12
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: less than 1 (dependent on serum total bilirubin)
• maximum score: over 90 (dependent on serum total bilirubin)
• The higher the score the greater the mortality.
• A score >= 34 predicted death in the hospital with a sensitivity of 77% and specificity of 97%.
Performance:
• The area under the ROC curve was 0.91
