majiayu000 LODS Score Calculation
The Logistic Organ Dysfunction Score (LODS) assesses organ dysfunction across 6 systems with logistic regression-derived weights. It provides mortality prediction based on the first ICU day.
When to Use This Skill
- Multi-organ dysfunction assessment
- Mortality prediction with organ-specific weighting
- Research on organ failure patterns
- Alternative to SOFA for organ dysfunction quantification
Score Components (First 24 Hours)
| System | Variables | Score Range |
|---|---|---|
| Neurologic | GCS | 0-5 |
| Cardiovascular | HR, SBP | 0-5 |
| Renal | BUN, Creatinine, Urine Output | 0-5 |
| Pulmonary | PaO2/FiO2 (ventilated only) | 0-3 |
| Hematologic | WBC, Platelets | 0-3 |
| Hepatic | PT, Bilirubin | 0-1 |
Total Range: 0-22
Pre-computed Table
SELECT
subject_id,
hadm_id,
stay_id,
lods,
neurologic,
cardiovascular,
renal,
pulmonary,
hematologic,
hepatic
FROM mimiciv_derived.lods;
Component Scoring Details
Neurologic (GCS)
| GCS | Score |
|---|---|
| <= 5 | 5 |
| 6-8 | 3 |
| 9-13 | 1 |
| 14-15 | 0 |
Cardiovascular
| Condition | Score |
|---|---|
| HR < 30 OR SBP < 40 | 5 |
| SBP < 70 OR SBP >= 270 | 3 |
| HR >= 140 OR SBP >= 240 OR SBP < 90 | 1 |
| Normal | 0 |
Renal
| Condition | Score |
|---|---|
| UO < 500 OR BUN >= 56 | 5 |
| Cr >= 1.6 OR UO < 750 OR BUN >= 28 OR UO >= 10000 | 3 |
| Cr >= 1.2 OR BUN >= 7.5 | 1 |
| Normal | 0 |
Pulmonary (Ventilated Patients Only)
| PaO2/FiO2 | Score |
|---|---|
| < 150 | 3 |
| >= 150 | 1 |
| Not ventilated | 0 |
Hematologic
| Condition | Score |
|---|---|
| WBC < 1.0 | 3 |
| WBC < 2.5 OR Platelets < 50 OR WBC >= 50 | 1 |
| Normal | 0 |
Hepatic
| Condition | Score |
|---|---|
| Bilirubin >= 2.0 OR PT > 15s OR PT < 3s | 1 |
| Normal | 0 |
Critical Implementation Notes
Prothrombin Time (PT): The "standard" PT is assumed to be 12 seconds. Abnormal is > 15s (12 + 3) or < 3s (12 * 0.25).
Pulmonary Scoring: Only scored for patients on mechanical ventilation or CPAP. Non-ventilated patients get 0.
CPAP Detection: Identified from oxygen delivery device documentation containing "cpap" or "bipap mask".
GCS < 3: Treated as null (erroneous value or tracheostomy).
Missing Data: Missing components are imputed as 0 (normal).
Example: Organ Dysfunction Profile
SELECT
stay_id,
lods,
neurologic,
cardiovascular,
renal,
pulmonary,
hematologic,
hepatic,
CASE WHEN neurologic > 0 THEN 1 ELSE 0 END +
CASE WHEN cardiovascular > 0 THEN 1 ELSE 0 END +
CASE WHEN renal > 0 THEN 1 ELSE 0 END +
CASE WHEN pulmonary > 0 THEN 1 ELSE 0 END +
CASE WHEN hematologic > 0 THEN 1 ELSE 0 END +
CASE WHEN hepatic > 0 THEN 1 ELSE 0 END AS n_failing_organs
FROM mimiciv_derived.lods
ORDER BY lods DESC;
Example: Multi-Organ Failure Analysis
-- Patients with >= 3 organ systems failing
SELECT
l.stay_id,
l.lods,
adm.hospital_expire_flag AS mortality
FROM mimiciv_derived.lods l
INNER JOIN mimiciv_icu.icustays ie ON l.stay_id = ie.stay_id
INNER JOIN mimiciv_hosp.admissions adm ON ie.hadm_id = adm.hadm_id
WHERE
(CASE WHEN neurologic > 0 THEN 1 ELSE 0 END +
CASE WHEN cardiovascular > 0 THEN 1 ELSE 0 END +
CASE WHEN renal > 0 THEN 1 ELSE 0 END +
CASE WHEN pulmonary > 0 THEN 1 ELSE 0 END +
CASE WHEN hematologic > 0 THEN 1 ELSE 0 END +
CASE WHEN hepatic > 0 THEN 1 ELSE 0 END) >= 3;
References
- Le Gall JR et al. "The Logistic Organ Dysfunction system: a new way to assess organ dysfunction in the intensive care unit." JAMA. 1996;276(10):802-810.