Hua et al developed a score for predicting unplanned intubation of an adult followng major surgery. The need for unplanned intubation is associated with increased morbitidy and mortality. The authors are from Columbia University in New York City.
Patient selection: age >= 16 years of age following major surgery
Parameters:
(1) age in years
(2) ASA class
(3) sepsis
(4) total operative time in minutes
|
Parameter |
Finding |
Points |
|
age in years |
16 to 39 years |
0 |
|
|
40 to 49 years |
1 |
|
|
50 to 59 years |
2 |
|
|
60 to 79 years |
3 |
|
|
>= 80 years |
4 |
|
ASA class |
1 or 2 |
0 |
|
|
3 |
3 |
|
|
4 or 5 |
7 |
|
sepsis |
no |
0 |
|
|
yes |
3 |
|
total operative time |
< 120 minutes |
0 |
|
|
120 tlo 259 minutes |
2 |
|
|
260 to 359 minutes |
3 |
|
|
>= 360 minutes |
4 |
total score = unplanned intubation risk index (UIRI)
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the risk of an unplanned intubation.
When the data in Figure 2 is modeled then the following table is generated.
|
UIRI |
Percent with Unplanned Intubation |
|
0 or 1 |
0% |
|
2 to 17 |
(0.05581 * ((points)^2)) + (0.0116 * (points)) - 0.221 |
|
18 |
16% |
Performance:
• The area under the ROC curve was 0.79.
Specialty: Anesthesiology, Surgery, general, Pulmonology, Cardiology, Emergency Medicine, Otolaryngology
