Hypotension Prediction Score (HYPS) of Smischney et al for Post-Intubation Hypotension in a Critically-Ill Adult: Model for the Full Cohort

Description

Smischney et al identified risk factors for hypotension following intubation in an adult in the intensive care unit (ICU). This can help to identify a high-risk patient who may require more aggressive management. The authors are from multiple institutions in the United States and members of the SCCM Discovery HEMAIR Investigators Consortium.

Patient selection: critically-illadult being intubated

Parameters:

(1) APACHE II score

(2) age in years

(3) sepsis

(4) intubation setting

(5) diuretics given in the past 24 hours

(6) catecholamines given in the 60 minutes prior to intubation

(7) phenylephrine given in the 60 minutes prior to intubation

(8) systolic blood pressure in mm Hg

(9) etomidate used for intubation

Parameter	Finding	Points
APACHE II score	<= 10	0
	11 to 15	1
	16 to 20	2
	21 to 25	3
	>= 26	4
age in years	<= 40 years	0
	41 to 50	0.5
	51 to 60	1
	61 to 70	1.5
	71 to 80	2
	>= 81 years	3
sepsis	no	0
	yes	1
intubation setting	respiratory failure	1
	MAP < 65 mm Hg	3.5
	cardiac arrest	2
	other	0
diuretics	no	0
	yes	3
catecholamines	no	0
	yes	5
phenylephrine	no	0
	yes	1
systolic blood pressure	< 90 mm Hg	10.5
	90 to 99 mm Hg	7
	100 to 109 mm Hg	5
	110 to 119 mm Hg	3
	120 to 129 mm Hg	1
	>= 130 mm Hg	0
etomidate	no	0
	yes	-1.5

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: -1.5

• maximum score: 31

Total Score	Risk Group	Hypotension
<= 1.5	low	12%
2 to 10.5	moderate	27%
11 to 18.5	high	58%
>= 19	very high	72%

Performance:

• The area under the ROC curve is 0.75

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Hypotension Prediction Score (HYPS) of Smischney et al for Post-Intubation Hypotension in a Critically-Ill Adult: Model for the Full Cohort

Description

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