Accumulative Prognostic Index for Patients with Barbiturate, Glutethimide and Meprobamate Intoxication

Abstract To assess and update prognosis in a group of critically ill patients, repetitive measurements of physiologic status were made in 52 patients who were comatose and in shock after attempting suicide by ingesting large doses of barbiturate, glutethimide or meprobamate. Only three variables were needed to provide the prognostic information contained in all 25 variables measured. A momentary prognostic index, which estimates the patient's probability of survival on the basis of a single set of measurements, and an accumulative prognostic index, which takes into account previous sets of measurements, were derived. The accumulative prognostic index may provide a more realistic assessment of prognosis, for it de-emphasizes transient fluctuations in the patient's condition and emphasizes directional changes as a function of time. Formulas were derived that permit calculation of this index by the clinician with the use of a desk-top calculator.