Ventilator Dependence Risk Score of Chang et al for Prolonged Mechanical Ventilation Following Sepsis with Respiratory Failure

Description

Chang et al reported the Ventilator Dependence Risk Score for evaluating a patient on a mechanical ventilator for respiratory failure associated with sepsis or septic shock. This can help to identify a patient at risk for prolonged mechanical ventilation. The authors are from Chang Gung University in Taiwan.

Patient selection: mechanical ventilation following sepsis or septic shock

Prolonged mechanical ventilation is defined by CMS as mechanical ventilation for both of the following:

(1) for > 21 days

(2) for >= 6 hours per day

Parameters:

(1) previous stroke

(2) platelet count per microliter on day 7 post-admission

(3) pH on day 7 post-admission

(4) FiO2 on day 7 post-admission

Parameter	Finding	Points
previous stroke	no	0
	yes	1
platelet count	> 150,000 per µL	0
	<= 150,000 per µL	1
pH	> 7.35	0
	<= 7.35	2
FiO2	< 0.39	0
	>= 0.39	2

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 6

• A score >= 1 is 81% sensitive and 50% specific for prolonged ventilation.

Performance:

• The area under the ROC curve is 0.73 for the derivation and 0.66 for the validation cohorts.

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Ventilator Dependence Risk Score of Chang et al for Prolonged Mechanical Ventilation Following Sepsis with Respiratory Failure

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