Evaluation of prognostic features that have been reported to predict mortality of patients undergoing mechanical ventilation after hematopoietic stem cell transplantation
| Author, year . | Poor prognostic feature . | N . | Prior (pretest) probability of death6-150 . | Test characteristics of feature in validation cohort . | Range of probabilities of death given prognostic feature (posttest probabilities) . | ||
|---|---|---|---|---|---|---|---|
| TPR (%) . | FPR (%) . | Likelihood ratio . | |||||
| Crawford et al, 19882 | Age ≥ 21 years | 226 | 82%-96% | 97 | 100 | 0.97 | 81%-96% |
| Denardo et al, 198921 | >4 days of ventilation | 176 | 82%-96% | 39 | 25 | 1.58 | 88%-97% |
| Faber-Langendoen et al, 19938 | Age ≥ 40 years | 226 | 82%-96% | 63 | 69 | 0.92 | 81%-96% |
| Intubated before 90 days | 226 | 82%-96% | 77 | 72 | 1.08 | 83%-96% | |
| Rubenfeld and Crawford, 19963 | 4 hours vasopressors6-151 | 206 | 82%-96% | 27 | 21 | 1.28 | 85%-97% |
| Lung injury6-152 | 222 | 82%-96% | 85 | 65 | 1.31 | 86%-97% | |
| Hepatic and renal injury6-153 | 207 | 82%-96% | 29 | 0 | 9.486-154 | 98%-100% | |
| LI combined with either HR or V6-155 | 224 | 82%-96% | 47 | 25 | 1.90 | 90%-98% | |
| Price et al,6-159 199823 | BMT rather than PBSCT | 180 | 82%-96% | 91 | 76 | 1.20 | 85%-97% |
| RR > 25 bpm | 180 | 82%-96% | 57 | 64 | 0.90 | 80%-96% | |
| Shorr et al, 199933 | Apache II score ≥ 29 | 226 | 82%-96% | 23 | 19 | 1.21 | 85%-97% |
| Huaringa et al, 200027 | HSCT for diagnosis other than breast cancer | 90 | 82%-96% | 93 | 84 | 1.11 | 84%-96% |
| Intubated after 30 days | 82%-96% | 47 | 41 | 1.15 | 84%-97% | ||
| Author, year . | Poor prognostic feature . | N . | Prior (pretest) probability of death6-150 . | Test characteristics of feature in validation cohort . | Range of probabilities of death given prognostic feature (posttest probabilities) . | ||
|---|---|---|---|---|---|---|---|
| TPR (%) . | FPR (%) . | Likelihood ratio . | |||||
| Crawford et al, 19882 | Age ≥ 21 years | 226 | 82%-96% | 97 | 100 | 0.97 | 81%-96% |
| Denardo et al, 198921 | >4 days of ventilation | 176 | 82%-96% | 39 | 25 | 1.58 | 88%-97% |
| Faber-Langendoen et al, 19938 | Age ≥ 40 years | 226 | 82%-96% | 63 | 69 | 0.92 | 81%-96% |
| Intubated before 90 days | 226 | 82%-96% | 77 | 72 | 1.08 | 83%-96% | |
| Rubenfeld and Crawford, 19963 | 4 hours vasopressors6-151 | 206 | 82%-96% | 27 | 21 | 1.28 | 85%-97% |
| Lung injury6-152 | 222 | 82%-96% | 85 | 65 | 1.31 | 86%-97% | |
| Hepatic and renal injury6-153 | 207 | 82%-96% | 29 | 0 | 9.486-154 | 98%-100% | |
| LI combined with either HR or V6-155 | 224 | 82%-96% | 47 | 25 | 1.90 | 90%-98% | |
| Price et al,6-159 199823 | BMT rather than PBSCT | 180 | 82%-96% | 91 | 76 | 1.20 | 85%-97% |
| RR > 25 bpm | 180 | 82%-96% | 57 | 64 | 0.90 | 80%-96% | |
| Shorr et al, 199933 | Apache II score ≥ 29 | 226 | 82%-96% | 23 | 19 | 1.21 | 85%-97% |
| Huaringa et al, 200027 | HSCT for diagnosis other than breast cancer | 90 | 82%-96% | 93 | 84 | 1.11 | 84%-96% |
| Intubated after 30 days | 82%-96% | 47 | 41 | 1.15 | 84%-97% | ||
Range of probabilities of death in presence of prognostic factors are based on combining prior probabilities of death determined from systematic review, with likelihood ratios determined on a validation cohort with a baseline mortality of 86%.
TPR indicates true-positive rate; FPR, false-positive rate; BMT, bone marrow transplant; PBSCT, peripheral blood stem cell transplantation.
Based on evaluation of 15 prior studies and the validation cohort.
Dopamine > 5 mcg/kg/min or norepinephrine, epinephrine, or phenylephrine at any dose at any time after admission.
Lung injury: fraction of inspired oxygen ≥ 60% or positive end expiratory pressure (PEEP) > 5 cm H20 after the first 24 hours of admission.
Simultaneous elevation of serum bilirubin > 68 μmol/L (4 mg/dL) and serum creatinine > 177 μmol/L (2 mg/dL) within the first 3 days of admission.
Defined as the presence of lung injury and one or more of the other characteristics (hepatic and renal injury or > 4 hours of vasopressors).
Estimated likelihood ratio given zero false-positive rate (details in “Methods”).
Evaluated on patients from the other 4 centers of the validation cohort, excluding the original study site (University of Texas M. D. Anderson Cancer Center).