THAI-ICU score as a simplified severity score for critically ill patients in a resource limited setting: Result from SEA-AKI study group

Purpose: To create a simplified ICU scoring system to predict mortality in critically ill patients that can be feasibly applied in resource limited setting with good performance of predicting hospital mortality.

Materials and methods: A retrospective study from prospective cohort was created consisting of adult patients who were admitted to an ICU of 17 centers across Thailand from 2013 to 2015. A development cohort (n = 3503) and a validation cohort (n = 1909) were randomly selected from the available enrollment data.

Results: In the development cohort, the predictors of the simplified score 6 variable model were low Glasgow coma score (GCS), low mean arterial pressure or need vasopressor, positive net-fluid balance, tachypnea, thrombocytopenia, and high blood urea nitrogen. In the validation study of THAI-ICU, AUC (95%CI) was 0.81(0.78-0.83). At the optimum cutoff value of 9; the sensitivity, specificity, positive likelihood ratio were 72%, 73%, and 2.72 respectively. The Hosmer-Lemeshow - C statistic was 13.5 (p = .2) and the Brier score 95% CI was 0.16 (0.15, 0.17).

Conclusions: The THAI-ICU score is a new simplified severity score for predicting hospital mortality. The simplicity of the score will increase the possibility to apply in resource limited settings.