Abstract
BackgroundThe 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.MethodsThis 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-fit test (calibration) and receiver operating characteristic (ROC) curves (discrimination) from ICU admission day until day 7. The outcome measure was ICU mortality.ResultsA 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.ConclusionsAlthough the LODS has not previously been validated for cardiac surgerypatients it showed reasonable accuracy in prediction of ICU mortality in patients after cardiac surgery.
Highlights
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
The authors constructed the score by analyzing the data from 14745 consecutive patients admitted to 137 medical, surgical, or mixed intensive care units (ICUs) in 12 different countries
The study included 2801 patients who were admitted to the ICU over the two-year period; 29.6% (n = 830) were female, and the mean age was 66.9 ± 10.7 years
Summary
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 b-coefficients. Le Gall et al initially proposed the Logistic Organ Dysfunction Score (LODS) (Table 1) in 1996 [1]. The authors constructed the score by analyzing the data from 14745 consecutive patients admitted to 137 medical, surgical, or mixed intensive care units (ICUs) in 12 different countries. Coronary care patients, and cardiac surgery patients were excluded from the dataset. In the last few years, some of the general scoring systems have been shown to be valid for use in cardiac
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