This MODS score for multiple organ failure calculator predicts ICU and hospital mortality along with the days spent in ICU by patients with multiorgan dysfunction. There is in depth information below the form on the clinical parameters used by MODS and on the final score interpretation.

1

PaO2/FiO2 ratio

2

Platelet count as 103/mm3

3

Serum bilirubin in mg/dL (μmol/L)

4

Pressure adjusted heart rate (HR*CVP/MAP)

5

Glasgow Coma Scale

6

Serum creatinine in mg/dL (μmol/L)

How does the MODS score for multiple organ failure calculator work?

This health tool determines ICU and hospital mortality and also the average predicted ICU stay in the case of patients with multiple organ failure.

MODS is a clinical syndrome characterized by acute progressive physiological dysfunction in at least 2 organs or organ systems. In most definitions, sepsis is included in the possible causes of MODS. Another name is multisystem organ failure (MSOF).

There are six parameters taken into account in the MODS score calculator:

■ The ratio between partial pressure of oxygen and fraction of inspired oxygen – this is measured directly for patients undergoing mechanical ventilation and estimated for those non-ventilated.

■ Platelet count – low platelet counts are indicative of infections, immunity deficiencies and MOF.

■ Serum bilirubin – in this case, this determination is used to provide information on liver function.

■ Pressure adjusted heart rate – which is heart rate multiplied by the ratio of the central venous pressure to the mean arterial pressure. In this case an indicator of cardiovascular function.

Glasgow coma scale – used in order to assess the level of consciousness of the patient in the following areas: visual, verbal and motor. Scores range between 3 and 15, the higher the score, the higher the level of consciousness. This is used as an indicator of central nervous system function.

Serum creatinine – this determination is used to provide information on renal function with baseline established at ≥4 mg/dL or ≥134 μmol/L.

The following table introduces the scores in each component of the MODS score for multiple organ failure.

MODS 0 1 2 3 4
PaO2/FiO2 ratio >300 226 - 300 151 - 225 76 - 150 0 - 75
Platelet count as 103/mm3 >120 81 - 120 51 - 80 21 - 50 ≤20
Serum bilirubin in mg/dL (μmol/L) ≤1.2 (20) 1.3 - 3.5 (21 - 60) 3.6 - 7.0 (61 - 120) 7.0 - 14 (121 - 240) >14 (240)
Pressure adjusted heart rate (HR*CVP/MAP) 0 - 10 10.1 - 15 15.1 - 20 20.1 - 30 >30.1
Glasgow Coma Scale 15 13 - 14 10 - 12 7 - 9 ≤6
Serum creatinine in mg/dL (μmol/L) ≤1.1 (100) 1.2 - 2.2 (101 - 200) 2.3 - 3.9 (201 - 350) 4.0 - 5.7 (351 - 500) >5.7 (500)

Multiple organ dysfunction score

Answers from all six of the parameters discussed above are summed to provide the final score which is then compared to the results in the below table:

MODS ICU mortality (%) Hospital mortality (%) ICU stay in days
0 0 0 2
1 - 4 1 - 2% 7% 3
5 - 8 3 - 5% 16% 6
9 - 12 25% 50% 10
13 - 16 50% 70% 17
17 - 20 75% 82% 21
21 - 24 100% 100% n/a

A simplified version of the MODS can be found in the modified Marshall score which uses the diagnosis capacity for organ failure in order to assess the severity of acute pancreatitis.

A similar score, the sequential organ failure assessment (SOFA) score, provides the evaluation of five of the above parameters, but it replaces pressure adjusted heart rate with just the mean arterial pressure. At the same time, the value ranges are slightly different between the two scores.

References

1) Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. (1995) Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med; 23(10):1638-52.

2) Nawaz H, Mounzer R, Yadav D, Yabes JG, Slivka A, Whitcomb DC, Papachristou GI. (2013) Revised Atlanta and determinant-based classification: application in a prospective cohort of acute pancreatitis patients. Am J Gastroenterol; 108(12):1911-7.

3) Jacobs S, Zuleika M, Mphansa T. (1999) The Multiple Organ Dysfunction Score as a descriptor of patient outcome in septic shock compared with two other scoring systems. Crit Care Med; 27(4):741-4.

4) Murray MJ, Coursin DB. (1993) Multiple Organ Dysfunction Syndrome. Yale Journal Of Biology And Medicine. 66, pp.501-510.

02 Oct, 2016 | 0 comments

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