Balkema et al developed a simple score for predicting mortality for an HIV-positive patient requiring mechanical ventilation in the ICU. This can help to identify a patient who may benefit from more aggressive management. The authors are from Stellenbosch University and Tygerberg Academic Hospital in Cape Town, South Africa.
Patient selection: HIV-positive patient in South Africa
Parameters:
(1) AIDS
(2) CD4 count in cells per microliter
(3) extrapulmonary tuberculosis
(4) Pneumocystis jirovecii pneumonia
(5) septic shock
(6) renal dysfunction (serum creatinine > 140 µmol/L in male, > 120 µmol/L in female)
Parameter
Finding
Points
AIDS
no
0
yes
1
CD4 count
>= 50 per µL
0
< 50 per µL
1
extrapulmonary TB
absent
0
present
1
Pneumocystis pneumonia
absent
0
present
1
septic shock
absent
0
present
1
renal dysfunction
no
0
yes
1
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of mortality.
Total Score
Mortality
0 to 2
24%
3
80%
4 to 6
100%
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