Figure 832

INDIVIDUAL SEVERITY INDEX Individual severity index (ISI). The ISI was published in its second version in 1993 [36]. The ISI estimates the probability of death. Nephrotoxic indicates an ARF of that origin; the other variables have been defined in preceding figures. The numbers preceding these keys denote the contribution of each one to the prognosis and are the factor for multiplying the clinical variables; 0.210 is the equation constant. Each clinical variable takes a value of 1 or 0, depending, respectively, on its presence or absence (with the exception of the age, which takes the value of the patient's decade). The parameters are recorded when the nephrologist sees the patient the first time. Calculation is easy: only a card with the equation values, a pen, and paper are necessary. A real example is given.

ISI=0.032 (age-decade) - 0.086 (male) - 0.109 (nephrotoxic) + 0.109 (oliguria) + 0.116 (hypotension) + 0.122 (jaundice) + 0.150 (coma) — 0.154 (consciousness) + 0.182 (assisted respiration) + 0.210

Case example

A 55-year-old man was seen because of oliguria following pancreatic surgery. At that moment he was hypotensive and connected to a respirator, and jaundice was evident. He was diagnosed with acute tubular necrosis. His ISI was calculated as follows:

ISI=0.032(6) — 0.086 + 0.109 + 0.116 + 0.122 + 0.182 + 0.210 = 0.845

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