From: Appendix 2, The new Intensive Care National Audit & Research Centre model: ICNARCH-2014
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Final coefficients for the ICNARCH-2014 risk prediction model for acute hospital mortality
Predictor | Coefficient (SE) |
---|---|
Constant | 19.093 (6.635) |
Physiological predictors | |
Highest heart rate (beats per minute) – RCS (71, 93, 110, 146) [106] | |
hr1 | –0.00005 (0.00325) |
hr2 | 0.05999 (0.01205) |
hr3 | –0.1927 (0.0350) |
Lowest SBP (mmHg) – RCS (66, 89, 102, 130) [95] | |
sbp1 | –0.03310 (0.00735) |
sbp2 | 0.10080 (0.02765) |
sbp3 | –0.3907 (0.1272) |
Highest temperature (°C) – RCS (36.0, 37.2, 38.0, 39.2) [37.6] | |
temp1 | –0.1530 (0.0548) |
temp2 | –0.1349 (0.3290) |
temp3 | 1.939 (1.495) |
Lowest respiratory rate (breaths per minute) – RRCS (8, 12, 13, 15) [13] | |
rr1 | –0.07682 (0.00690) |
rr2 | 0.00772 (0.01019) |
rr3 | –0.01448 (0.01426) |
rr4 | 0.00698 (0.00797) |
rr5 | 0.00024 (0.00014) |
PaO2/ FiO2 (kPa) – RCS (9.7, 26.0, 39.7, 61.4) [33.0] | |
pf1 | –0.04360 (0.00438) |
pf2 | 0.07204 (0.01510) |
pf3 | –0.17258 (0.04498) |
Lowest arterial pH – RCS (7.08, 7.30, 7.36, 7.44) [7.31] | |
ph1 | –0.6547 (0.8709) |
ph2 | –4.2092 (1.3490) |
ph3 | 29.727 (22.008) |
PaCO2 (kPa) – RCS (3.9, 5.2, 7.0) [5.4] | |
pc1 | 2.89904 (0.64885) |
pc2 | 0.47630 (0.13307) |
Highest blood lactate concentration (mmol/l) – RCS (0.7, 1.5, 2.5, 8.2) [2.8] | |
bl1 | –11.0662 (3.2726) |
bl2 | 188.9267 (51.7254) |
bl3 | –351.1491 (95.6690) |
Urine output (ml) – RCS (164, 1215, 2020, 4255) [1800] | |
up1 | –0.00136 (0.00009) |
up2 | 0.002416 (0.00035) |
up3 | –0.00466 (0.00097) |
Highest urea level (mmol/l) – RCS (2.8, 5.6, 9.3, 28.1) [10.5] | |
ur1 | –0.07858 (0.02591) |
ur2 | 1.8777 (0.36564) |
ur3 | –3.4724 (0.6610) |
Highest creatinine level (µmol/l) – RRCS (53, 80, 106, 168) [141] | |
cr1 | 0.00213 (0.00012) |
cr2 | 0.29314 (0.12838) |
cr3 | –0.11159 (0.05119) |
cr4 | 0.02867 (0.00790) |
cr5 | –0.00035 (0.00006) |
Highest sodium level (mmol/l) – RCS (133, 139, 145) [139] | |
na1 | –0.05476 (0.00357) |
na2 | 0.05908 (0.00386) |
Lowest WBC count (× 109/l) – RCS (3.7, 8.7, 12.3, 22.5) [12.0] | |
wbc1 | –0.03935 (0.00759) |
wbc2 | 0.21809 (0.03518) |
wbc3 | –0.60698 (0.10216) |
Lowest platelet count (× 109/l) – RCS (60, 162, 232, 422) [211] | |
plc1 | –0.00646 (0.00041) |
plc2 | 0.02136 (0.00171) |
plc3 | –0.05719 (0.00520) |
Sedated/paralysed/GCS score [15] | |
15 | 0 |
14 | 0.277 (0.0320) |
7–13 | 0.533 (0.0294) |
Sedated | 0.745 (0.0295) |
6 | 0.849 (0.0914) |
5 or paralysed and sedated | 0.928 (0.0582) |
4 | 1.273 (0.1142) |
3 | 1.751 (0.0596) |
Non-physiological predictors | |
Age (years) | 0.03723 (0.00073) |
Severe liver disease in past medical history | 11.224 (6.501) |
Metastatic disease | 0.621 (0.0524) |
Haematological malignancy | 0.673 (0.0583) |
Dependency prior to admission | |
No assistance with daily activities | 0 |
Some assistance with daily activities | 0.474 (0.0205) |
Total assistance with daily activities | 0.890 (0.0870) |
CPR prior to admission | |
Community CPR | 0 |
In-hospital CPR | 10.892 (3.500) |
No CPR | 3.732 (2.449) |
Source of admission/urgency of surgery | |
ED or not in hospital (unplanned admission) | 0 |
ED or not in hospital (planned admission) | 0.022 (0.1169) |
Other acute hospital (not critical care) | 0.369 (0.0838) |
Other critical care unit (repatriation) | 0.593 (0.1131) |
Other critical care unit (planned or unplanned transfer) | 0.257 (0.0430) |
Theatre (planned admission following elective or scheduled surgery) | –0.934 (0.0518) |
Theatre (unplanned admission following elective or scheduled surgery) | –0.455 (0.0694) |
Theatre (admission following emergency or urgent surgery) | –0.223 (0.0359) |
Ward or intermediate care area | 0.405 (0.0264) |
Primary reason for admission | |
Accidental intoxication or poisoning (endocrinea) | –0.080 (0.2578) |
Acidaemia (endocrine) | –0.117 (0.2274) |
Burns or hyperthermia (dermatological) | 1.004 (0.3180) |
Collapse (respiratory) | 2.157 (0.6381) |
Coma or encephalopathy (neurological) | 0.463 (0.2030) |
Congenital or acquired deformity or abnormality (cardiovascular) | 0 |
Congenital or acquired deformity or abnormality (musculoskeletal) | –0.196 (0.2330) |
Congenital or acquired deformity or abnormality (neurological) | –2.853 (1.3406) |
Congenital or acquired deformity or abnormality (respiratory) | 0.940 (0.2046) |
Congenital or acquired deformity or abnormality (endocrine; gastrointestinal; genitourinary; or haematological/immunological) | 0.040 (0.2081) |
Degeneration (cardiovascular) | –0.194 (0.2209) |
Degeneration (neurological) | 1.837 (0.3511) |
Diabetes mellitus (endocrine) | –0.494 (2.8285) |
Dissection or aneurysm (cardiovascular) | 0.246 (0.1817) |
Failure (cardiovascular) | 0.574 (0.1848) |
Failure (genitourinary) | 0.257 (0.1774) |
Haemorrhage (cardiovascular) | –0.366 (0.3263) |
Haemorrhage (gastrointestinal) | 8.352 (2.8243) |
Haemorrhage (genitourinary) | –0.574 (0.2988) |
Haemorrhage (neurological) | 0.370 (0.6378) |
Haemorrhage (respiratory) | 0.214 (0.2583) |
Hyperkalaemia (endocrine) | 0.011 (0.2464) |
Hypertension (cardiovascular) or over- or under-activity (cardiovascular; genitourinary) | 0.198 (0.1800) |
Hypokalaemia (endocrine) | –0.494 (0.4010) |
Hyponatraemia (endocrine) | –0.268 (0.2864) |
Hypoplasia or dysplasia (haematological/immunological) | 0.651 (0.3303) |
Hypothermia (endocrine) | 0.190 (0.2953) |
Infection (cardiovascular) | 0.775 (0.2100) |
Infection (genitourinary) | –0.140 (0.1885) |
Infection (respiratory) | 2.116 (0.5798) |
Infection (dermatological; gastrointestinal; haematological/immunological; musculoskeletal; or neurological) | 0.372 (0.1758) |
Inflammation (gastrointestinal) | 0.486 (0.1799) |
Inflammation (neurological) | –0.191 (0.2739) |
Inflammation (respiratory) | 0.377 (0.1785) |
Inflammation (cardiovascular; dermatological; genitourinary; musculoskeletal) | –0.017 (0.2435) |
Obstruction (cardiovascular) | 0.220 (0.1776) |
Obstruction (gastrointestinal) | 0.437 (0.1783) |
Obstruction (genitourinary) | –0.420 (0.2600) |
Obstruction (respiratory) | 0.158 (0.1792) |
Other endocrine processesa (endocrine) | –0.1557 (0.2333) |
Seizures (neurological) | –0.138 (0.1872) |
Self intoxication or self poisoning (endocrine) | 0.513 (1.0021) |
Shock and hypotension (cardiovascular) | 0.410 (0.1770) |
Transplant or related (gastrointestinal) | –1.125 (0.2922) |
Transplant or related (cardiovascular; endocrine; genitourinary; haematological/immunological; respiratory) | 0.153 (0.3162) |
Trauma, perforation or rupture (cardiovascular) | 0.128 (0.2558) |
Trauma, perforation or rupture (gastrointestinal) | 0.398 (0.1771) |
Trauma, perforation or rupture (neurological) | –0.475 (3.8994) |
Trauma, perforation or rupture (dermatological; genitourinary; musculoskeletal; respiratory) | 0.260 (0.1827) |
Tumour or malignancy (genitourinary) | 0.052 (0.2007) |
Tumour or malignancy (haematological/immunological) | 0.116 (0.2997) |
Tumour or malignancy (neurological) | 0.590 (0.6974) |
Tumour or malignancy (cardiovascular; dermatological; endocrine; gastrointestinal; musculoskeletal; respiratory) | 11.442 (2.581) |
Vascular (cardiovascular) | 0.593 (0.1989) |
Vascular (gastrointestinal) | 0.654 (0.1897) |
Vascular (neurological) | 1.294 (0.2195) |
Acute alcoholic hepatitis/alcoholic cirrhosis | 0.670 (0.8356) |
Anaphylaxis | –0.950 (0.3475) |
Anoxic or ischaemic coma or encephalopathy | 0.687 (1.3371) |
Asthma attack in new or known asthmatic | –1.132 (0.2533) |
Enteroenteric or enterocutaneous fistula | 1.667 (0.3242) |
Fractured ribs | 0.249 (0.2571) |
Fungal or yeast pneumonia | 1.255 (0.2413) |
Haemolysis or thrombocytopenia | –0.027 (0.3676) |
Hanging or strangulation | 1.790 (0.2644) |
Intracerebral haemorrhage | 32.963 (14.5399) |
Leaking large bowel anastomosis/perforated biliary tree or gall bladder | 0.670 (0.8356) |
Lower limb artery stenosis or occlusion | 1.009 (0.2054) |
Pulmonary fibrosis or fibrosing alveoli | 2.919 (0.2727) |
Secondary hydrocephalus | –2.218 (6.1830) |
Thrombo-occlusive disease of brain | 1.899 (0.2010) |
Toxic or drug-induced coma or encephalopathy | 0.129 (0.2480) |
Mechanical ventilation | 0.7160 (0.4495) |
Interactions | |
Arterial pH × PaCO2 | |
ph1 × pc1 | –0.42784 (0.09097) |
ph1 × pc2 | –0.03535 (0.01712) |
ph2 × pc1 | 0.58168 (0.21846) |
ph3 × pc1 | –1.14392 (3.91387) |
Arterial pH × blood lactate concentration | |
ph1 × bl1 | 1.563 (0.4481) |
ph1 × bl2 | –26.37 (7.0874) |
ph1 × bl3 | 49.00 (13.111) |
ph2 × bl1 | –0.1573 (0.12837) |
ph3 × bl1 | 7.797 (2.4084) |
Urine output × urea | |
up1 × ur1 | 0.00005 (0.00001) |
up1 × ur2 | –0.00065 (0.00015) |
up1 × ur3 | 0.00116 (0.00027) |
up2 × ur1 | –0.00002 (0.00002) |
up3 × ur1 | 0.00005 (0.00005) |
Liver disease × temperature | |
temp1 | –0.2845 (0.17794) |
temp2 | 0.9400 (0.49252) |
temp3 | –4.648 (1.8547) |
CPR × SBP | |
In-hospital CPR × sbp1 | 0.00043 (0.00940) |
In-hospital CPR × sbp2 | 0.01370 (0.03616) |
In-hospital CPR × sbp3 | –0.03798 (0.16478) |
No CPR × sbp1 | 0.01281 (0.00753) |
No CPR × sbp2 | –0.07066 (0.02817) |
No CPR × sbp3 | 0.31309 (0.12912) |
CPR × temperature | |
In-hospital CPR × temp1 | –0.3232 (0.09522) |
In-hospital CPR × temp2 | 0.8444 (0.45897) |
In-hospital CPR × temp3 | –3.230 (2.0050) |
No CPR × temp1 | –0.1547 (0.06646) |
No CPR × temp2 | 0.2818 (0.34462) |
No CPR × temp3 | –1.556 (1.5416) |
Collapse (respiratory) × platelet count | |
plc1 | –0.01305 (0.00547) |
plc2 | 0.02428 (0.02238) |
plc3 | –0.04071 (0.06688) |
Congenital (neurological) × urine output | |
up1 | 0.00324 (0.00150) |
up2 | –0.01064 (0.00576) |
up3 | 0.02702 (0.01488) |
Diabetes mellitus (endocrine) × heart rate | |
hr1 | 0.00544 (0.03384) |
hr2 | –0.1944 (0.11643) |
hr3 | 0.7147 (0.32881) |
Haemorrhage (gastrological) × sodium level | |
na1 | –0.05819 (0.02074) |
na2 | 0.02272 (0.02189) |
Haemorrhage (neurological) × urine output | |
up1 | –0.00010 (0.00050) |
up2 | 0.00080 (0.00188) |
up3 | –0.00157 (0.00484) |
Haemorrhage (neurological) × blood lactate concentration | |
bl1 | 0.8467 (0.34277) |
bl2 | –6.623 (5.9342) |
bl3 | 11.09 (11.197) |
Infection (respiratory) × heart rate | |
hr1 | –0.01412 (0.00655) |
hr2 | 0.03690 (0.02251) |
hr3 | –0.1021 (0.06348) |
Infection (respiratory) × PaO2/FiO2 | |
pf1 | –0.01559 (0.00611) |
pf2 | –0.01082 (0.02796) |
pf3 | 0.13753 (0.09825) |
Self poisoning (endocrine) × creatinine level | |
cr1 | –0.00098 (0.00174) |
cr2 | –0.94067 (2.33612) |
cr3 | 0.44148 (0.70236) |
cr4 | –0.13545 (0.09162) |
cr5 | 0.00024 (0.00073) |
Self poisoning (endocrine) × blood lactate concentration | |
bl1 | –1.347 (0.6578) |
bl2 | 29.70 (10.375) |
bl3 | –56.39 (19.128) |
Trauma (neurological) × sodium level | |
na1 | –0.00217 (0.02855) |
na2 | 0.04362 (0.02519) |
Trauma (neurological) × WBC count | |
wbc1 | 0.07408 (0.07799) |
wbc2 | –0.04864 (0.31443) |
wbc3 | 0.23081 (0.88934) |
Trauma (neurological) × urine output | |
up1 | 0.0004 (0.00047) |
up2 | –0.00050 (0.00180) |
up3 | 0.00118 (0.00462) |
Trauma (neurological) × platelet count | |
plc1 | 0.00290 (0.00327) |
plc2 | –0.02458 (0.01346) |
plc3 | 0.06889 (0.04086) |
Tumour (haematological/immunological) × WBC count | |
wbc1 | 0.06610 (0.06833) |
wbc2 | 0.5778 (0.51906) |
wbc3 | –2.313 (1.6231) |
Tumour (neurological) × urine output | |
up1 | 0.00007 (0.00075) |
up2 | 0.00033 (0.00282) |
up3 | –0.00053 (0.00722) |
Tumour (other) × sodium level | |
na1 | –0.08002 (0.01897) |
na2 | 0.06770 (0.02276) |
Acute alcoholic hepatitis/alcoholic cirrhosis × urea level | |
ur1 | 0.02320 (0.17484) |
ur2 | 2.009 (2.6257) |
ur3 | –4.264 (4.7798) |
Anoxic/ischaemic coma × SBP | |
sbp1 | 0.00209 (0.01739) |
sbp2 | 0.08982 (0.05797) |
sbp3 | –0.3009 (0.24374) |
Intracerebral haemorrhage × temperature | |
temp1 | –0.8292 (0.39703) |
temp2 | 0.6162 (0.94252) |
temp3 | 0.1163 (3.23562) |
Intracerebral haemorrhage × urine output | |
up1 | –0.00026 (0.00055) |
up2 | 0.00181 (0.00212) |
up3 | –0.00401 (0.00551) |
Secondary hydrocephalus × creatinine level | |
cr1 | –0.02572 (0.03126) |
cr2 | –0.53674 (2.02834) |
cr3 | –0.30353 (1.05165) |
cr4 | 0.06243 (0.23562) |
cr5 | 0.00220 (0.00542) |
Mechanical ventilation × heart rate | |
hr1 | 0.00386 (0.00416) |
hr2 | –0.04434 (0.01538) |
hr3 | 0.1481 (0.04462) |
Mechanical ventilation × respiratory rate | |
rr1 | 0.03380 (0.01191) |
rr2 | –0.01425 (0.01245) |
rr3 | 0.03415 (0.01803) |
rr4 | –0.01939 (0.01019) |
rr5 | –0.00004 (0.00020) |
Mechanical ventilation × PaO2/FiO2 | |
pf1 | 0.02427 (0.00523) |
pf2 | –0.05202 (0.001912) |
pf3 | 0.14406 (0.05891) |
Mechanical ventilation × PaCO2 | |
pc1 | –0.1153 (0.03488) |
pc2 | 0.02085 (0.03791) |
ED, emergency department; RCS, restricted cubic splines (knot positions in parentheses); RRCS, right-restricted cubic splines (knot positions in parentheses).
Square brackets indicate mean/normal value for imputation.
Alcohol-related disorders, alkalaemia, chromosomal deletion syndromes, contiguous gene syndromes, envenomation, fluid overload, haemorrhage, hypercalcaemia, hyperglycaemia, hypernatraemia, hyperthermia, hypocalcaemia, hypoglycaemia, inborn errors of metabolism, obesity, over-activity, sex chromosome disorders, starvation, trisomy and under-activity.
From: Appendix 2, The new Intensive Care National Audit & Research Centre model: ICNARCH-2014
Included under terms of UK Non-commercial Government License.
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.