Logistic Organ Dysfunction Score (LODS): A reliable postoperative risk management score also in cardiac surgical patients?

This prospective study included all consecutive adult patients who were admitted tothe intensive care unit (ICU) after cardiac surgery between January 2007 and December 2008. The LODS was calculated daily from the first until the seventh postoperative day. Performance was assessed with Hosmer-Lemeshow (HL) goodness-of-fit test (calibration) and receiver operating characteristic (ROC) curves (discrimination) from ICU admission day until day 7. The outcome measure was ICU mortality.A total of 2801 patients (29.6% female) with a mean age of 66.4 ± 10.7 years wereincluded. The ICU mortality rate was 5.2% (n = 147). The mean stay on the ICU was 4.3 ± 6.8 days. Calibration of the LODS was good with no significant difference between expected and observed mortality rates on any day (p ≥ 0.05). The initial LODS had an area under the ROC curve (AUC) of 0.81. The AUC was best on ICU day 3 with a value of 0.93, and declined to 0.85 on ICU day 7.Although the LODS has not previously been validated for cardiac surgerypatients it showed reasonable accuracy in prediction of ICU mortality in patients after cardiac surgery.Le Gall et al. initially proposed the Logistic Organ Dysfunction Score (LODS) (Table 1) in 1996 [1]. The authors constructed the score by analyzing the data from 14745 consecutive patients admitted to 137 medical, surgical, or mixed intensive care units (ICUs) in 12 different countries. Burn patients, coronary care patients, and cardiac surgery patients were excluded from the dataset.In the last few years, some of the general scoring systems have been shown to be valid for use in cardiac surgery patients [2]. Validation of the Sequential Organ Failure Assessment (SOFA) score in 218 cardiac surgical patients has demonstrated that general ICU-scoring systems may be reliable in this patient subgroup without any modification [2]. We, therefore, hypothesized that the LODS might have good predictive power for risk of mortality in cardiac surgical patients.This study invol