Qi et al reported a nomogram for predicting in-hospital mortality for a patient who has had gastrointestinal surgery. This can help to identify a patient who may require more aggressive management. The authors the Third Xiangya Hospital of Central South University in Changsha, China.
Note: The nomogram is unusual with ranges of parameters very narrow, making for variability in reading points. Also the range of the total score is only from 0.82 to 4.5.
Patient selection: adult status post gastrointestinal surgery
Parameters:
(1) use of vasopressors
(2) serum BUN in mg/dL from 2.5 to 142
(3) serum lactate in mmol/L from 0 to 14.45
(4) mean arterial pressure (MAP) in mm Hg, from 56.36 to 122.61
(5) respiratory rate in breaths per minute from 9.78 to 33.49
(6) temperature in °C from 33.2 to 38.73
(7) age in years from 20.20 to 91.40
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Vasopressor Use
|
Points
|
|
no
|
0
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yes
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0.373
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points for BUN =
= (0.00588 * (BUN)) - 0.0147
points for lactate =
= (0.05937 * (lactate))
points for MAP =
= (0.00704 * (MAP)) - 0.02364
points for respiratory rate =
= (0.02989 * (rate)) + 0.00607
points for temperature =
= 9.92692 - (0.25631 * (temperature))
points for age =
= (0.00707 * (age)) + 0.00635
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0.8206
• maximum score: 4.554
value of X =
= 4.171 * (score)) - 12.56
[robability of in-hospital mortality =
= 1 / (1 + EXP(-1) * X))
Performance:
• The area under the ROC curve is 0.87 in the training and 0.81 in the validation corhots.
