Estimation of the mortality risk of surgical intensive care patients based on routine laboratory parameters.
BACKGROUND
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.


METHODS
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).


RESULTS
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.


CONCLUSIONS
A general admission risk score for surgical intensive care patients solely based on quality controlled low-cost routine laboratory parameters is feasible.
Stachon
A
A
Institute of Clinical Chemistry, Transfusion and Laboratory Medicine, Ruhr University Bochum, Bochum, Germany. Axel.Stachon@ruhr-uni-bochum.de
Becker
A
A
Holland-Letz
T
T
Friese
J
J
Kempf
R
R
Krieg
M
M
D015415:Biomarkers / Q000097:blood*; D003422:Critical Care / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000401:mortality*; D003955:Diagnostic Tests, Routine; D005240:Feasibility Studies; D005260:Female; D006305:Health Status Indicators; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
D015415:Biomarkers