The Organ Dysfunctions and/or Infection (ODIN) model assesses the number and type of organ dysfunctions in the intensive care patient. This information can be used to predict the patient's outcome.
Organ System |
|
Finding |
---|---|---|
respiratory |
|
PaO2 < 60 mm Hg on FIO2 0.21 |
|
OR |
need for ventilatory support |
cardiovascular (excluding patients showing hypovolemia, with CVP < 5 mm Hg) |
|
systolic arterial pressure < 90 mm Hg with signs of peripheral hypoperfusion |
|
OR |
continuous infusion of vasopressor or inotropic agents required to maintain systolic pressure > 90 mm Hg |
renal (excluding patients on chronic hemodialysis before hospital admission) |
|
serum creatinine > 3.4 mg/dL (300 µmol/L) |
|
OR |
urine output < 500 mL in 24 hours or < 180 mL in 8 hours |
|
OR |
need for hemodialysis or peritoneal dialysis |
neurologic |
|
Glasgow coma scale <= 6 in the absence of sedation at any time during day |
|
OR |
sudden onset of confusion or psychosis |
hepatic |
|
serum bilirubin > 5.9 mg/dL (100 µmol/L) |
|
OR |
alkaline phosphatase > 3 times normal |
hematologic |
|
hematocrit <= 20 per cent |
|
OR |
white blood cell count < 2,000 per µL |
|
OR |
platelet count < 40,000 per µL |
infection (with clinical evidence of infection) |
|
2 or more positive blood cultures |
|
OR |
presence of gross pus in a closed space |
|
OR |
source of infection determined during hospitalization, or at autopsy in case of death within 24 hours |
where:
• conversion for bilirubin from mg/dL to µmol/L is 17.1; reverse 0.0585
• conversion for creatinine from mg/dL to µmol/L is 88.4; reverse 0.0113
ODIN score =
= (1 if respiratory dysfunction present) + (1 if cardiovascular dysfunction present) + (1 if renal dysfunction present) + (1 if neurologic dysfunction present) + (1 if hepatic dysfunction present) + (1 if hematologic dysfunction present) + (1 if infection present)
Interpretation:
• maximum score = 7
• minimum score = 0
ODIN Score |
Mortality |
---|---|
0 |
2.6% |
1 |
9.7% |
2 |
16.7% |
3 |
32.3% |
4 |
64.9% |
5 |
75.9% |
6 |
94.4% |
7 |
100% |
Logistic Regression Analysis
q =
= (-3.59) + (1.09 if respiratory dysfunction) + (1.19 if cardiovascular dysfunction) + (1.18 if renal dysfunction) + (0.86 if hematologic dysfunction) + (0.57 if hepatic dysfunction) + (0.99 if neurologic dysfunction) + (0.53 if infection present)
probability of death =
= (1 / (1 + EXP (-q)))
Purpose: To use the organ dysfunctions and/or infection (ODIN) model to predict the mortality of a patient in intensive care.
Specialty: Critical Care, Emergency Medicine
Objective: severity, prognosis, stage
ICD-10: A40, A41,