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Estimation of the Mortality Risk of Surgical Intensive Care Patients Based on Routine Laboratory Parameters

2008; Karger Publishers; Volume: 40; Issue: 3 Linguagem: Inglês

10.1159/000113106

1421-9921

Axel Stachon, Andreas Becker, Tim Holland‐Letz, J. Friese, Raymond A. Kempf, Michael Krieg,

Cardiac, Anesthesia and Surgical Outcomes

<i>Background:</i> In established risk score models the collection and documentation of clinical data is time-consuming, causes labor-related costs, and is dependent on the examiner. <i>Material and Methods:</i> Based on low-cost laboratory parameters that are routinely measured at admission to the intensive care unit, a new score was developed (n = 271, study sample) and validated in an independent group of patients (n = 283, validation sample). Parameters were selected by a stepwise logistic regression analysis. This new score was compared to established risk models (APACHE II, SAPS II). <i>Results:</i> Mean age was 61.3 ± 1.2 years (study sample) and 63.1 ± 1.1 years (validation sample), respectively. In-hospital mortality was 24.7% (67/271, study sample) and 23.3% (66/283, validation sample). The following parameters were used to build the new score called Dense Laboratory Whole Blood Applied Risk Estimation (DELAWARE): alanine aminotransferase, C-reactive protein, cholesterol, creatine kinase MB, leukocytes, potassium, thrombocytes, triglycerides, and age. The areas under the curves were 0.853/0.813 (study sample/validation sample). In the study sample DELAWARE correlated with APACHE II (r = 0.586) and SAPS II (r = 0.614; p < 0.001), respectively. <i>Conclusions:</i> A general admission risk score for surgical intensive care patients solely based on quality controlled low-cost routine laboratory parameters is feasible.