Boer et al developed a nomogram for predicting post-traumatic stress disorder (PTSD) in patients admitted to the intensive care unit for intra-abdominal sepsis. These can help to identify a patient who may benefit from an intervention to reduce the severity of the symptoms. The authors are from Academic Medical Center Amsterdam and the Dutch Peritonitis Study Group.
Patient selection: 40 to 80 years of age admitted to the ICU for intra-abdomminal sepsis
Parameters:
(1) age in years
(2) length of ICU stay in days
(3) gender
(4) major comorbidity (COPD, renal failure, malignancy, diabetes, cardiovascular disease, etc)
(5) other trauma
(6) hospital and ICU memories
points for age =
= (-0.3 * (age in yeaers)) + 24
|
ICU Stay |
Points |
|
< 5 days |
0 |
|
5 to 80 days |
(0.16 * (days)) – 0.8 |
|
> 80 days |
12 |
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
1 |
|
major comorbidity |
no |
0 |
|
|
yes |
7 |
|
other trauma |
no |
0 |
|
|
yes |
8 |
|
memories of ICU/hospital |
none or mild |
0 |
|
|
moderate |
15 |
|
|
severe |
40 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 80
• The higher the score the greater the risk of severe PTSD memories.
|
Score |
Probability of Low Symptoms |
|
0 to 40 |
(-0.03643 * ((points)^2)) + (0.067 * (points)) + 97.71 |
|
30 to 70 |
(0.035 * ((points)^2)) - (5.09 * (points)) + 188.6 |
|
> 70 |
< 4% |
|
Score |
Probability of Moderate Symptoms |
|
0 to 40 |
(0.02857 * ((points)^2)) + (0.057 * (points)) + 2.114 |
|
40 to 70 |
(-0.06857 * ((points)^2)) + (6.917 * (points)) - 116.1 |
|
> 70 |
< 32% |
|
Score |
Probability of High Symptoms |
|
0 to 20 |
< 1% |
|
20 to 70 |
(0.03054 * ((points)^2)) - (1.505 * (points)) + 19.5 |
|
> 70 |
> 64% |
Specialty: Psychiatry
