Kuo et al reported several predictors for mortality of an adult trauma patient in the ICU. These can help to identify a patient who may require more aggressive management. The authors are from Chang Gung University in Kaohsiung, Taiwan.
Patient selection: adult trauma patient in the ICU
Predictors of mortality from multivariate analysis:
(1) age (OR 1.02; people over 70 have worse outcomes; people under 45 have better outcomes)
(2) end-stage renal disease (ESRD, OR 2.9)
(3) easy albumin-bilirubin score (EZ-ALBI, OR 1.1)
(4) Glasgow coma score (OR 0.85; all patients with a GCS of 15 survived while the prognosis if less than 9 was poor)
(5) injury severity score (OR 1.07; good if less than 20 and poor if over 25)
Additional predictors from the univariate analysis:
(1) hypertension
(2) coronary artery disease (CAD)
(3) congestive heart failure
EZ-ALBI score =
= (serum total bilirubin in mg/dL) - (9 * (serum albumin in g/dL))
An EZ-ALBI >= -26.5 is associated with increased mortality. For a serum total bilirubin of 1.0 mg/dL, this corresponds to a serum albumin of 3.0 g/dL.
