Yang et al reported a nomogram for predicting short-term mortality for a cancer patient with cancer. This can help to identify a patient who may require more aggressive management. The authors are from Peking University in Beijing.
Patient selection: cancer patient with sepsis
Parameters:
(1) neutrophil to lymphocyte ratio (NLR) on day 3
(2) serum procalcitonin on day 3 in ng/mL
(3) fluid accumulation over 72 hours in the ICU in mL per kg
(4) SOFA score
points for NLR =
= 0.625 * (percent neutrophils) /(percent lymphocytes)
points for procalcitonin =
= 0.0084 * (procalcitonin)
points for fluid accumulation =
= (0.2225 * (fluid accumulation)) + 22.45
points for SOFA =
= 1.473 * (SOFA)
total score =
= SUM(points for the four parameters)
Interpretation:
• minimum score: 0
• maximum score: 269.3
value of X =
= (0.1187 * (score)) - 10.06
The equation for X given in the paper (page 2347) =
= (0.048 * (NLR)) + (0.003 * (procalcitonin)) + (0.023 * (fluid)) + (0.134 * (SOFA)) - 6.768
probability of 28-day mortality =
= 1 / (1 + EXP((-1) * X))
Performance:
• The C value is 0.94 in the derivation and 0.97 in the validation cohorts
