Translation of prognostic features reported to be predictive of mortality in hematopoietic stem cell transplantation patients who require mechanical ventilation: original definition and definition used for validation
| Prognostic feature (author, year) . | Original definition . | Definition used for validation . |
|---|---|---|
| Prolonged ventilation (Denardo et al, 1989)21 | More than 4 days of mechanical ventilation. | More than 72 hours of mechanical ventilation. |
| Lung injury (Rubenfeld and Crawford, 1996)3 | FIO2 ≥ 60% or PEEP > 5 at any point after the first ICU day. | FIO2 ≥ 60% at the commencement of the second or fourth ICU day.* |
| Vaso-pressor support (Rubenfeld and Crawford, 1996; Jackson et al, 1997)3 31 | More than 4 hours of a continuous infusion of dopamine (>5 μg/kg/min), norepinephrine, epinephrine, or phenylephrine at any point after ICU admission. | More than 1 hour of a continuous infusion of dopamine (>3 μg/kg/min), norepinephrine, epinephrine, phenylephrine, dobutamine, amrinone, or milrinone within the first 3 days of ICU admission. |
| Combined hepatic and renal dysfunction (Rubenfeld and Crawford, 1996)3 | Simultaneous elevation of serum bilirubin (>68 μmol/L or 4 mg/dL) and serum creatinine (>177 μmol/L or 2 mg/dL) within the first 3 days of admission. | Simultaneous elevation of serum bilirubin (>68 μmol/L or 4 mg/dL) and serum creatinine (>177 μmol/L or 2 mg/dL) upon admission, at 24 hours, or at 72 hours after ICU admission. |
| APACHE II22† (Shorr, 1999)33 | APACHE II combines measures of acute physiologic derangements and chronic health problems. In Shorr's analysis, all patients received 5 chronic health points.‡ | Acute physiology component calculated using the more extreme value for each variable as recorded upon ICU admission and at 24 hours after ICU admission. All patients received 5 chronic health points. |
| Prognostic feature (author, year) . | Original definition . | Definition used for validation . |
|---|---|---|
| Prolonged ventilation (Denardo et al, 1989)21 | More than 4 days of mechanical ventilation. | More than 72 hours of mechanical ventilation. |
| Lung injury (Rubenfeld and Crawford, 1996)3 | FIO2 ≥ 60% or PEEP > 5 at any point after the first ICU day. | FIO2 ≥ 60% at the commencement of the second or fourth ICU day.* |
| Vaso-pressor support (Rubenfeld and Crawford, 1996; Jackson et al, 1997)3 31 | More than 4 hours of a continuous infusion of dopamine (>5 μg/kg/min), norepinephrine, epinephrine, or phenylephrine at any point after ICU admission. | More than 1 hour of a continuous infusion of dopamine (>3 μg/kg/min), norepinephrine, epinephrine, phenylephrine, dobutamine, amrinone, or milrinone within the first 3 days of ICU admission. |
| Combined hepatic and renal dysfunction (Rubenfeld and Crawford, 1996)3 | Simultaneous elevation of serum bilirubin (>68 μmol/L or 4 mg/dL) and serum creatinine (>177 μmol/L or 2 mg/dL) within the first 3 days of admission. | Simultaneous elevation of serum bilirubin (>68 μmol/L or 4 mg/dL) and serum creatinine (>177 μmol/L or 2 mg/dL) upon admission, at 24 hours, or at 72 hours after ICU admission. |
| APACHE II22† (Shorr, 1999)33 | APACHE II combines measures of acute physiologic derangements and chronic health problems. In Shorr's analysis, all patients received 5 chronic health points.‡ | Acute physiology component calculated using the more extreme value for each variable as recorded upon ICU admission and at 24 hours after ICU admission. All patients received 5 chronic health points. |
FIO2 indicates fraction of inspired oxygen; PEEP, positive and expiratory pressure; DA, dopamine; NE, norepinephrine; EPI, epinephrine; ICU, intensive care unit.
A “day” refers to a 24-hour period.
The predictive power of the Apache III scoring system was not assessed.32
Personal Communication, A. Shorr, December 10, 1999.