Predicting Hyperglycemic Crisis Death (PHD) Score of Huang et al

Description

Huang et al developed a score for predicting the risk of death associated with a hyperglycemia crisis in a patient with diabetes. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals and universities in Taiwan.

Patient selection: hyperglycemic crisis

Parameters:

(1) heart rate

(2) systolic blood pressure

(3) anemia (hemoglobin < 10 g/dL or hematocrit < 30%)

(4) coma based on Glasgow Coma Score (GCS)

(5) history of cancer

(6) infection as precipitating factor

Parameter	Finding	Points	Beta Coefficient
heart rate	> 100 beats per minute	0	0
	<= 100 beats per minute	1	1.569
systolic blood pressure	>= 90 mm Hg	0	0
	< 90 mm Hg	1	1.881
hemoglobin	>= 10 g/dL	0	0
	< 10 g/dL	1	2.43
Glasgow coma score	GCS >= 9	0	0
	GCS <= 8	1	1.886
history of cancer	no	0	0
	yes	1	2.425
infection as precipitating factor	no	0	0
	yes	2	4.192

total score =

= SUM(points for all 6 parameters)

X =

= SUM(beta-coeffcients for the 6 parameters) - 7.629

probability of death =

= 1 / (1 + EXP((-1) * X))

Interpretation:

• minimum score: 0

• maximum score: 7

• The higher the score the greater the risk of death.

Total Score	Risk Group	Mortality Rate
0 to 2	low	0%
3	intermediate	26%
4 to 7	high	60%

A patient at low risk can be managed conservatively while a patient at high risk should be admitted to the ICU.

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Description

Specialty

ICD-10