Logistic Organ Dysfunction Score (LODS), a reliable postoperative risk management score also in cardiac surgical patients?

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 β-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-offit test (calibration) and receiver operating characteristic (ROC) curves (discrimination) from ICU admission day until day 7. The outcome measure was ICU mortality.

Risk Models That Use Postoperative Patient Monitoring Data to Predict Outcomes in Adult Cardiac Surgery: A Systematic Review

“…Cardiac surgery patients were again excluded. In 2011 Heldwein et al showed that daily LODS scores could be used to predict mortality in cardiac surgery patients, [37] with the best discrimination observed on the third postoperative day.…”

Balancing operating theatre and bed capacity in a cardiothoracic centre

“…The potential of a long stay on the ICU may be inevitable for some patients but perhaps others might benefit from having their surgery postponed until they are in a medical state that might reduce the chance of such a long stay. Some studies have noted a correlation between the ICU length of stay and the severity of a patient's condition, as measured by the logistic organ dysfunction score (LODS) (Heldwein et al, 2011). However, this relationship appears valid for just specific categories of patients (Mallor & Azcárate, 2011).…”

Eventos adversos a medicamentos em idosos de unidades de terapia intensiva

“…O pior valor de todas as variáveis coletadas durante as primeiras 24 horas, após a admissão na UTI, é assumido como o score de SAPS II74 .O índice de LODS considera gravidade relativa e o grau de comprometimento de seis sistemas orgânicos, a saber: neurológico (Glasgow), cardiovascular (frequência cardíaca e pressão arterial sistólica), renal (uréia, creatinina), pulmonar (PaO2 e FiO2), hematológico (leucócitos, plaquetas) e hepático (bilirrubina, tempo de protrombiona)73 . O escore total varia de zero a 22 pontos: zero indica ausência de disfunção e 22 o nível de gravidade mais alto e seu valor pode ser convertido em probabilidade de óbito hospitalar75 .Os rastreadores de EAM, os quais foram analisados neste estudo exclusimente quanto as RAM foram identificados utilizando-se a metodologia adaptada do instrumento de rastreamento segundo a proposta do IHI , de acordo com a realidade da instituição pesquisada22 .No ano de 2010, o instrumento foi traduzido para o português e adaptado para a realidade de um hospital brasileiro28 . Nessa versão, ele foi composto por 21 rastreadores; destes, 12 são relacionados ao uso de medicamentos, cinco a alterações nos exames laboratoriais, que podem estar associadas ao uso de medicamentos, e quatro aos prováveis sinais e sintomas manifestados pelos pacientes após o uso de determinados medicamentos.…”