Comparison of Critical Illness Score in Patients Admitted to Intermediate Care Units of a Tertiary Care Hospital: A Comparative Cross-Sectional Study from Karachi, Pakistan

PiO₂/FiO₂: (mmHg)

<400 = 1 point, <300 = 2 points, <200 = 3 points, <100 = 4 points

Serum Creatinine: (mg/dl)

1.2–1.9 = 1 point, 2.0–3.4 = 2 points, 3.5–4.9 = 3 points, ≥5 = 4 points

0– 6

7 – 9

10 – 12

13 – 14

15

15– 24

<10%

15–20%

40–50%

50–60%

>80%

>90%

Platelets: (× 10³/uL)

<150 = 1 point, <100 = 2 points, <50 = 3 points, <20 = 4 points

GCS: (out of 15)

13–14 = 1 point, 10–12 = 2 points, 6–9 = 3 points, <6 = 4 points

MAP/Use of Vasopressor:

MAP < 70 mm/Hg = 1 point

dopamine ≤ 5 μg/kg/min or dobutamine (any dose) = 2 point

dopamine > 5 μg/kg/min OR epinephrine ≤ 0.1 μg/kg/min OR norepinephrine ≤ 0.1 μg/kg/min = 3 points

dopamine > 15 μg/kg/min OR epinephrine > 0.1 μg/kg/min OR norepinephrine > 0.1 μg/kg/min = 4 points

Bilirubin: (mg/dl)

1.2– 1.9 = 1 point, 2.0– 5.9 = 2 points, 6.0 – 11.9 = 3points, >12 = 4 points

RR: (breath/min)

≤8 = 2 points, 15–20 = 1 point, 21–29 = 2 points, ≥30 = 3 points

HR: (beats/min)

<40 = 2 points, 40–50 = 1 point, 101–110 = 1 point 111–129 = 2 points, >129 = 3points

Systolic blood pressure: (mmHg)

≤70 = 3 points, 71–80 = 2 points, 81–100 = 1 point, >200 = 2 points

Temperature: (°C)

≤34 = 3 points, 34.1–35 = 2 points, 35.1–36 = 1 point, 38–38.5 = 1 point, ≥38.6 = 2 points

CNS:

Unresponsive = 3 points, Respond to pain = 2 points, Respond to voice/New agitation/Confusion = 1 point

Urine Output: (ml in 24hr)

<480 = 2 points, 480–714 = 1 point, >4800 = 1 point

Age: (<44 years = 0 point)

45–54 = 2 points, 55–64 = 3 points, 65–74 = 5 points, >74 = 6 points

Temperature: (Normal: 36– 38.4°C)

≥ 41 / ≤ 29.9 = 4 points, 39–40.9 / 30–31.9 = 3 points,- / 32–33.9 = 2 points, 38.5–38.9 / 34–35.9 = 1 point

Mean Arterial Pressure (Normal: 70–109 mmHg)

≥160 / ≤ 49 = 4 points, 130–159 /- = 3 points, 110–129 / 50–69 = 2 points

Heart Rate (Normal: 70–109 bpm)

≥180 / ≤ 39 = 4 points, 140–179 / 40–54 = 3 points, 110–139 / 55–69 = 2 points

Respiratory Rate (Normal: 12–24 breath/min)

≥50 / ≤ 5 = 4 points, 35–49 /- = 3 points,- / 6–9 = 2 points, 25–34 / 10–11 = 1 point

Oxygenation (mmHg)

If FiO₂ ≥ 0.5, use A-a O₂: ≥500 = 4 points, 350–499 = 3 points, 200–349 = 2 points, <200 = 0 point

If FiO₂ < 0.5, use P_AO2: <55 = 4 points, 55–60 = 3 points, 61–70 = 1 points, >70 = 0 point

Arterial pH (Normal: 7.33–7.49)

≥ 7.7 / ≤ 7.15 = 4 points, 7.6.7.69 / 7.15–7.24 = 3 points,- / 7.25–7.32 = 2 points, 7.5–7.59 /- = 1 point

Serum HCO₃ (N: 22–31.9 mmol/L) ‘if ABGs unavailable’

≥ 52 / < 15 = 4 points, 41–51.9 / 15–17.9 = 3 points,- / 18–21.9 = 2 points, 32–40.9 /- = 1 point

Serum Na (Normal: 130–149 mmol/L)

≥ 180 / ≤ 110 = 4 points, 160–179 / 111–119 = 3 points, 155–159 / 120–129 = 2 points, 150–154 /- = 1 point

Serum K (Normal: 3.5–5.4 mmol/L)

≥ 7 / ≤ 2.5 = 4 points, 6–6.9 /- = 3 points,- / 2.5–2.9 = 2 points, 5.5–5.9 / 3–3.4 = 1 point

Serum Cr (Normal: 0.6–1.4 mg/dL) Score × 2 (if AKI)

≥ 3.5 /- = 4 points, 2–3.4 /- = 3 points, 1.5–1.9 / <0.6 = 2 points

Hematocrit (Normal: 30–45.9%)

≥ 60 / < 20 = 4 points, 50–59.9 / 20–29.9 = 2 points, 46–49.9/- = 1 point

WBCs (Normal: 3–14.9 ×10³/uL)

≥ 40 / < 1 = 4 points, 20–39.9 / 1–2.9 = 2 points, 15–19.9 /- = 1 point

GCS = Score: 15 – actual GCS

Chronic Health Status:

2 points = elective postoperative patient with immunocompromise or history of severe organ insufficiency

5 points = non-operative patient or emergency postoperative patient with immunocompromise or severe organ insufficiency

Temperature (°C)

<39 = 0 point, ≥39 = 3 points

Systolic Blood Pressure (mmHg)

<70 = 13 points, 70–99 = 5 points, 100–199 = 0 point, ≥200 = 2 points

Heart Rate (bpm)

≥ 160 = 7 points, 120–159 = 4 points, 70–119 = 0 point, 40–69 = 2 points, <40 = 11 points

PaO₂/FiO₂ (mmHg) = only if on VENT or CPAP

<100 = 11 points, 100–199 = 9 points, ≥200 = 7 points

Urine Output (liter/day)

<0.5 = 11 points, 0.5–0.99 = 4 points, ≥ 1 = 0 point

Urea (g/L)

<0.6 = 0 point, 0.6–1.7 = 6 points, >1.88 = 10 points

Serum HCO₃ (mmol/L)

<15 = 6 points, 15–19 = 3 points, >20 = 0 point

Serum Na (mmol/L)

<125 = 5 point, 125–144 = 0 point, ≥145 = 1 point

Serum K (mmol/L)

< 3 = 3 points, 3–4.9 = 0 point, ≥ 5 = 2 points

WBCs (×10³/uL)

< 1 = 12 points, 1–19.9 = 0 point, ≥ 20 = 2 points

Bilirubin (mg/dL)

< 40 = 0 point, 40–59.9 = 4 points, ≥ 60 = 9 points

GCS (out of 15)

< 6 = 26 points, 6–8 = 13 points, 9–10 = 7 points, 11–13 = 5 points, 14–15 = 0 point

Age (years)

<40 = 0 point, 40–59 = 7 points, 60–69 = 12 points, 70–74 = 15 points, 75–79 = 16 points, >80 = 18 points

Chronic disease

Metastatic cancer = 9 points, Hematological malignancy = 10 points, AIDS = 17 points

Type of Admission

Elective/Surgery = 0 point, Medical = 6 points, Emergency Surgery = 8 points