Grosso et al reported 2 nomograms for predicting the risk of admission to the intensive care unit (ICU) after a total hip arthroplasty (THA). One model reports the risk for a revision procedure. The authors are from the Connecticut Joint Replacement Institute and Rothman Orthopedic Institute in Philadelphia.
Patient selection: revision total hip arthroplasty
Parameters:
(1) heart disease
(2) neurological disease
(3) renal disease
(4) age in years, from 10 to 100
(5) number of joints
(6) preoperative hemoglobin in g/dL, from 0 to 20
(7) preoperative blood glucose in mg/dL, from 0 to 500
(8) current smoker
points for age =
= (1.11 * (age)) - 11.11
points for hemoglobin =
= 49.3 - (2.47 * (hemoglobin))
points for blood glucose =
= 0.186 * (glucose)
|
Parameter
|
Finding
|
Points
|
|
heart disease
|
no
|
0
|
|
|
yes
|
18.7
|
|
neurological disease
|
no
|
0
|
|
|
yes
|
51
|
|
renal disease
|
no
|
0
|
|
|
yes
|
12.1
|
|
number of joints
|
1 (unilateral)
|
0
|
|
|
2 (bilateral)
|
36.4
|
|
current smoker
|
no
|
0
|
|
|
yes
|
25.3
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 385.74
• The higher the score the greater the risk of ICU admission.
value of X =
= (0.0607 * (score)) - 11.54
probability of ICU admission =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.80.
