The Logistic Organ Dysfunction (LOD) System provides a means to assess patients in the intensive care unit (ICU) for severity of critical organ dysfunction. From this information it is possible to predict the probability of death for the patient.
Data Collection: All data elements ideally should be collected at least once during the first 24 hours in the ICU.
(1) If an element is not measured, then it is assumed to be normal for scoring purposes.
(2) If an element is tested more than once during the first 24 hours, then the most severe value is used.
Organ scores:
(1) neurologic
(2) cardiovascular
(3) renal
(4) pulmonary
(5) hematologic
(6) hepatic
Neurologic Score
|
Glasgow Coma Score |
Points |
|
14-15 |
0 |
|
9-13 |
1 |
|
6-8 |
3 |
|
< 6 |
5 |
Note: Use the lowest value. If the patient is sedated, estimate the score prior to sedation.
Cardiovascular Score
|
heart rate per minute |
operator |
systolic blood pressure in mm Hg |
Points |
|
30-139 |
AND |
90-239 |
0 |
|
>=140 |
OR |
240-269 |
1 |
|
|
|
70-89 |
1 |
|
|
|
>= 270 |
3 |
|
|
|
40-69 |
3 |
|
<30 |
OR |
< 40 |
5 |
Note: Use the most abnormal value for heart rate or systolic blood pressure, either minimum or maximum.
Renal Score
|
serum urea nitrogen in mg/dL |
oper-ator |
creatinine in mg/dL |
oper-ator |
urine output in liters per day |
Points |
|
< 17 |
AND |
< 1.20 |
AND |
0.75 - 9.99 |
0 |
|
17 - 27.99 |
OR |
1.2 - 1.59 |
|
|
1 |
|
28 - 55.99 |
OR |
>= 1.60 |
OR |
>= 10 |
3 |
|
|
|
|
|
0.5 - 0.74 |
3 |
|
>= 56 |
|
|
|
|
5 |
|
|
|
|
|
< 0.5 |
5 |
Notes:
(1) Use the highest value for SUN and for creatinine.
(2) If the only data for urine output is for a period less than 24 hour period, adjust that value to 24 hours assuming the same rate of excretion.
(3) If the patient is on hemodialysis, use the value of urine output prior to initiating hemodialysis.
Pulmonary Score
|
On ventilation or CPAP? |
operator |
ratio (PaO2 in mm Hg) / (FIO2) |
Points |
|
No |
|
|
0 |
|
Yes |
AND |
>= 150 |
1 |
|
Yes |
AND |
< 150 |
3 |
Note: If the patient is receiving respiratory support, use the lowest ratio of PaO2 to FIO2.
Hematologic Score
|
white blood cell count |
operator |
platelet count |
Points |
|
2,500 to 49,900 /µL |
AND |
>= 50,000 /µL |
0 |
|
>= 50,000 /µL |
|
|
1 |
|
1,000 to 2,499 /µL |
OR |
< 50,000 /µL |
1 |
|
< 1,000 /µL |
|
|
3 |
Note:
(1) Use the most abnormal value for the white cell count, either minimum or maximum.
(2) Use the minimum platelet count if several values are available.
(3) In applying the rules, the OR for the platelet count < 50,000 per µL can be problematic if the WBC is < 1,000 per µL.
Hepatic Score
|
bilirubin |
operator |
prothrombin time |
Points |
