Postinjury Multiple Organ Failure Prognosis Model - Medical Algorithm

Description

Sauaia et al developed models for predicting the probability multiple organ failures following multiple organ failure based on data collected during the first 24 hours after admission to the hospital. This can help identify those patients who may require more aggressive monitoring and management. The authors are from the University of Colorado and University of Texas Houston.

NOTE: The information here is from the 12 and 24 hour models. Models were also developed for admission and at 48 hours.

Selection criteria:

(1) Injury Severity Score > 15

(2) age > 15 years

(3) survival > 48 hours

(4) admitted to the hospital < 48 hours after the injury

Parameters:

(1) Injury Severity Score (ISS) as measure of tissue injury

(2) RBC transfusion on admission

(3) RBC transfusion following admission

(4) inotropic drug therapy

(5) platelet count

(6) age

(7) serum lactate level

Parameter	Finding	Points for 12 Hour	Points for 24 Hour
ISS score	< 16	0	0
	16 - 25	0	0
	26 - 40	0.37	0.40
	> 40	1.26	1.23
RBC transfusion on admission	no	0	0
	yes	0.20	0.04
RBC transfusion after admission during 12 hours	no	0	0
	yes	0.06	0.05
inotropic drugs after admission during 12 hours	none or low dose	0	0
	moderate to high dose	0.77	-0.58
inotropic drugs after admission during 13 - 24 hours	none or low dose	NA	0
	moderate to high dose	NA	1.81
platelet count on admission	not tested	0	0
	>= 80,000 per µL	0.27	0.54
	< 80,000 per µL	2.09	2.12
platelet count at 13 - 24 hours	not tested	NA	0
	>= 80,000 per µL	NA	-0.32
	< 80,000 per µL	NA	1.13
serum lactate at 13 - 24 hours	not tested	NA	0
	<= 4 mmol/L	NA	0.18
	> 4 mmol/L	NA	1.28
age of the patient	<= 45 years	0	0
	> 45 years	1.08	0.81

from Table 5, page 296

where:

• The platelet counts are given "per dL" in Table 5, which appears to be an error.

• I assume the lactate concentration is based on arterial samples.

X =

= SUM(points for the 12 hour model) -3.23

probability of developing multiple organ failure based on the first 12 hour data =

= 1 / (1 + EXP((-1) * X))

Y =

= SUM(points for the 24 hour model) -3.50

probability of developing multiple organ failure based on the first 24 hour data =

= 1 / (1 + EXP((-1) * Y))

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Description

Specialty

Objective

ICD-10

Model of Sauaia et al for Predicting the Probability of Multiple Organ Failure Based on Data Available During the First 24 Hours After Traumatic Injury

Purpose: Purpose: To predict the probability of developing multiple organ failure in a patent following traumatic injury using the model of Sauaia et al.

Description

Specialty

Objective

ICD-10