The Organ System Failure Index is a measure of organ failure in 7 organ systems. It correlates with ICU outcome.
Organs:
(1) renal
(2) hepatic
(3) pulmonary
(4) bone marrow
(5) neurologic
(6) gastrointestinal
(7) cardiac
Renal criteria - one or both of the following:
(1) 2 fold increase in baseline creatinine concentration
(2) absolute increase in creatinine concentration by 2 mg/dL
Hepatic criteria:
(1) increase in total bilirubin concentration to > 2.0 mg/dL
Pulmonary criteria- one of the following:
(1) requiring mechanical ventilation for pneumonia, COPD, asthma, pulmonary edema
(2) PaO2 < 60 mm Hg while receiving FIO2 >= 0.50
(3) use of >= 10 cm H2O of positive end-expiratory pressure (PEEP)
Bone marrow criteria- one of the following:
(1) presence of DIC
(2) white blood cell count < 1,000 per µL
(3) platelet count < 75,000 per µL
Neurologic criteria- one or both of the following:
(1) onset of a new focal deficit (hemiparesis after cerebral infarction, other)
(2) new generalized process (seizures, coma, other)
Gastrointestinal criteria- one of the following:
(1) gastrointestinal hemorrhage requiring blood transfusion
(2) new ileus lasting > 24 hours unrelated to prior bowel surgery
(3) diarrhea lasting > 24 hours lasting > 24 hours unrelated to prior bowel surgery
Cardiac criteria - one or more of the following:
(1) acute myocardial infarction
(2) cardiac arrest
(3) new onset of congestive heart failure
organ system failure index =
= SUM(number of organs meeting criteria)
Interpretation:
• minimum index: 0
• maximum index: 7
• ICU mortality increases with the number of organ failures.
