The risk for developing seizures in Intensive Care Unit (ICU) patients with Gram-negative infections can be estimated using an additive predictive risk index.
Population:
(1) ICU patients with serious Gram-negative infections
(2) seizures were divided into early onset (within 48 hours of ICU admission) and late onset
Derivation of clinical risk score:
(1) factors identified by multiple logistic regression
(2) the weight assigned is based on rounding the regression coefficient to the nearest integer
History
Factor
Weight
history before admission
prior history of seizures
2
any previous or current CNS tumors
4
concurrent factors before onset of seizure
acute stroke, intracranial hemorrhage, CNS surgery or CNS infection during or within 1 month before hospitalization
3
coma or anoxic encephalopathy while in the ICU
1
renal impairment (serum creatinine > 1.6 mg/dL, or dialysis)
2
acute hypotensive episode while in the ICU
1
clinical risk score =
= SUM(weights present)
Interpretation:
• minimum clinical risk score = 0
• maximum clinical risk score = 13
• clinical risk score <=2 indicates low risk for seizures
• clinical risk score >= 3 indicates a high risk for seizures
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