Ressources et utilitaires

Scoring systems for ICU and surgical patients:

24-hour I.C.U. Trauma Score

Variables (help)	Values	Points
Neurologic (help)	no brain injury brain injury and Glasgow 13-15 brain injury and Glasgow 9-12 brain injury and Glasgow 6-8 brain injury and Glasgow 4-5 brain injury and Glasgow 3
Pulmonary	extubated intubated and PaO2/FIO2 >= 325 intubated and PaO2/FIO2 225-324 intubated and PaO2/FIO2 175-224 intubated and PaO2/FIO2 125-174 intubated and PaO2/FIO2 < 125
Cardiovascular	24 hour I.C.U. fluid balance < 3 L 24 hour I.C.U. fluid balance > = 3 L
Predicted Death Rate   Logit = (-3.900) + (0.911 * (neurologic points)) + (0.588 * (pulmonary points)) + (0.468 * (cardiovascular points)) Predicted death rate = 1/(1+e(-Logit))		24 h ICU Trauma score= Score = Sum (Points)

References

• Vassar MJ et al. Comparison of APACHE II, TRISS, and a proposed 24-hour ICU point system for prediction of outcome in ICU trauma patients. J Trauma 1992;32:490-500.
• Vassar MJ et al. Prediction of outcome in intensive care unit trauma patients: a multicenter study of Acute Physiology and Chronic Health Evaluation (APACHE), Trauma and Injury Severity Score (TRISS), and 24-hour intensive care unit (ICU) point system. J Trauma 1999;47:324-9.

Patients and variables

Patients excluded : burn injuries and less than 16 years of age.

Data are collected within the first 24 hours after ICU admission.

If a patient is admitted after the beginning of the shift when the 24 hour period is first recorded, it will be necessary to abstract intake and and output totals from a portion of the record from the second day.

The fluid balance component is not helpful in patients with isolated head injuries whose fluid intakes are restricted.

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Eyes Open	Verbal	Motor
Spontaneous To speech To pain Absent	Converses / Oriented Converses / Disoriented Inappropriate Incomprehensible Absent	Obeys Localizes pain Withdraws (flexion) Decorticate (flexion) rigidity Decerebrate (extension) rigidity Absent

Glasgow=

For patients who are intubated, the GCS verbal points are assigned as follows :
5 points if eye + motor = 10
3 if eye + motor = 7 or 8
1 if eye + motor <= 6

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