Heldwein, Matthias B., Badreldin, Akmal M. A., Doerr, Fabian, Lehmann, Thomas, Bayer, Ole, Doenst, Torsten and Hekmat, Khosro (2011). Logistic Organ Dysfunction Score (LODS): A reliable postoperative risk management score also in cardiac surgical patients? J. Cardiothorac. Surg., 6. LONDON: BIOMED CENTRAL LTD. ISSN 1749-8090

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Abstract

Background: The original Logistic Organ Dysfunction Sore (LODS) excluded cardiac surgerypatients from its target population, and the suitability of this score in cardiac surgery patients has never been tested. We evaluated the accuracy of the LODS and the usefulness of its daily measurement in cardiac surgery patients. The LODS is not a true logistic scoring system, since it does not use beta-coefficients. Methods: This prospective study included all consecutive adult patients who were admitted tothe intensive care unit (ICU) after cardiac surgery between January 2007 and December 2008. The LODS was calculated daily from the first until the seventh postoperative day. Performance was assessed with Hosmer-Lemeshow (HL) goodness-of-it test (calibration) and receiver operating characteristic (ROC) curves (discrimination) from ICU admission day until day 7. The outcome measure was ICU mortality. Results: A total of 2801 patients (29.6% female) with a mean age of 66.4 +/- 10.7 years wereincluded. The ICU mortality rate was 5.2% (n = 147). The mean stay on the ICU was 4.3 +/- 6.8 days. Calibration of the LODS was good with no significant difference between expected and observed mortality rates on any day (p >= 0.05). The initial LODS had an area under the ROC curve (AUC) of 0.81. The AUC was best on ICU day 3 with a value of 0.93, and declined to 0.85 on ICU day 7. Conclusions: Although the LODS has not previously been validated for cardiac surgerypatients it showed reasonable accuracy in prediction of ICU mortality in patients after cardiac surgery.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Heldwein, Matthias B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Badreldin, Akmal M. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerr, FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehmann, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bayer, OleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doenst, TorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hekmat, KhosroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-488981
DOI: 10.1186/1749-8090-6-110
Journal or Publication Title: J. Cardiothorac. Surg.
Volume: 6
Date: 2011
Publisher: BIOMED CENTRAL LTD
Place of Publication: LONDON
ISSN: 1749-8090
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
INTENSIVE-CARE UNIT; SYSTEM FAILURE; SURGERY PATIENTS; MORTALITY; MODELS; DETERMINANTS; PROGNOSIS; SEVERITY; SEPSISMultiple languages
Cardiac & Cardiovascular Systems; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/48898

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