cliot (version 1.0.0)

mcmahon_rhabdo_score: McMahon Score for Rhabdomyolysis Risk

Description

Calculates the McMahon Score to predict the risk of renal failure (requiring renal replacement therapy) or in-hospital mortality in patients with rhabdomyolysis. A score of 5 or greater indicates a significantly higher risk and may warrant more aggressive fluid resuscitation or monitoring.

Usage

mcmahon_rhabdo_score(age, sex, etiology_high_risk, cpk, bicarbonate, creatinine,
                     calcium, phosphate, creatinine_units = "mg/dL",
                     calcium_units = "mg/dL", phosphate_units = "mg/dL")

Value

A list containing:

McMahon_Score

The calculated risk score (Range 0-10+).

Risk_Category

Classification (Low Risk vs. High Risk).

Risk_Renal_Failure_or_Death

Estimated percentage risk.

Arguments

age

Numeric. Patient age in years. <50: 0 pts. 50-70: 1.5 pts. 71-80: 3 pts. >80: 4.5 pts.

sex

String. Patient sex ("Male" or "Female"). Female sex adds 1 point.

etiology_high_risk

Numeric (0 or 1). Is the etiology "Other" (e.g., trauma, compartment syndrome, ischemia, sepsis, surgery)? (1 = Yes, +3 pts). Note: Select 0 for seizures, syncope, exercise, drug toxicity, statins, or myositis.

cpk

Numeric. Initial CPK (Creatine Phosphokinase) level in U/L. (>40,000 adds 2 pts).

bicarbonate

Numeric. Initial serum bicarbonate in mEq/L or mmol/L. (<19 adds 2 pts).

creatinine

Numeric. Initial serum creatinine. <1.4 mg/dL: 0 pts. 1.4-2.2 mg/dL: 1.5 pts. 2.3-4.5 mg/dL: 3 pts. >4.5 mg/dL: 4.5 pts.

calcium

Numeric. Initial serum calcium. (<7.5 mg/dL adds 2 pts).

phosphate

Numeric. Initial serum phosphate. <4.0 mg/dL: 0 pts. 4.0-5.4 mg/dL: 1.5 pts. >=5.5 mg/dL: 3 pts.

creatinine_units

String. Units for creatinine. "mg/dL" (default) or "umol/L".

calcium_units

String. Units for calcium. "mg/dL" (default) or "mmol/L".

phosphate_units

String. Units for phosphate. "mg/dL" (default) or "mmol/L".

References

McMahon GM, Zeng X, Waikar SS. A risk prediction score for kidney failure or mortality in rhabdomyolysis. JAMA Intern Med. 2013;173(19):1821-1828. doi:10.1001/jamainternmed.2013.9774

Examples

# Example 1: Low Risk
# Male, 30yo, Exercise induced, CPK 20k, normal labs
mcmahon_rhabdo_score(30, "male", 0, 20000, 24, 0.9, 9.0, 3.5)

# Example 2: High Risk
# Female, 75yo (+3 +1), Trauma (+3), CPK 50k (+2), Acidosis (+2), Cr 2.0 (+1.5)
# Score = 12.5
mcmahon_rhabdo_score(75, "female", 1, 50000, 18, 2.0, 8.0, 3.5)