mrc_icu_score: Medication Regimen Complexity-Intensive Care Unit (MRC-ICU) Score

Description

Calculates the MRC-ICU score, a tool designed to quantify the complexity of medication regimens in critically ill patients. The score is a weighted sum of prescribed medications and supportive therapies (e.g., mechanical ventilation, dialysis). Higher scores are associated with increased mortality, ICU length of stay, and pharmacist workload.

Usage

mrc_icu_score(aminoglycosides = 0, amphotericin_b = 0, antiarrhythmics = 0,
              anticoagulants_oral = 0, anticonvulsants = 0, argatroban = 0,
              azole_antifungals = 0, blood_products = 0, chemotherapy = 0,
              clozapine = 0, digoxin = 0, ganciclovir_valganciclovir = 0,
              hyperosmolar_fluids = 0, immunosuppressants = 0,
              lidocaine_infusion = 0, lithium = 0, prostacyclins = 0,
              theophylline = 0, therapeutic_heparins = 0, vancomycin_iv = 0,
              warfarin = 0, thromboembolic_prophylaxis = 0,
              stress_ulcer_prophylaxis = 0, glycemic_control = 0,
              bowel_regimen = 0, chlorhexidine = 0, inhalers_nebulizers = 0,
              continuous_sedation = 0, continuous_vasopressors = 0,
              continuous_inotropes = 0, continuous_nmba = 0,
              continuous_iv_fluids = 0, parenteral_nutrition = 0,
              fluid_bolus = 0, renal_replacement_therapy = 0,
              mechanical_ventilation = 0)

Value

A list containing:

MRC_ICU_Score: The total calculated score.
Interpretation: Context regarding score implications.

Arguments

aminoglycosides: Numeric. Number of aminoglycoside orders (e.g., Amikacin, Gentamicin). Weighted 3 points each.
amphotericin_b: Numeric. Number of Amphotericin B orders. Weighted 1 point.
antiarrhythmics: Numeric. Number of antiarrhythmic orders (e.g., Amiodarone, Sotalol). Weighted 1 point.
anticoagulants_oral: Numeric. Number of oral anticoagulant orders (DOACs, Fondaparinux). Weighted 1 point.
anticonvulsants: Numeric. Number of anticonvulsant orders (e.g., Phenytoin, Levetiracetam). Weighted 3 points.
argatroban: Numeric. Number of Argatroban orders. Weighted 2 points.
azole_antifungals: Numeric. Number of Azole antifungal orders (e.g., Voriconazole). Weighted 2 points.
blood_products: Numeric. Number of blood product orders (Factors, ATIII). Weighted 2 points.
chemotherapy: Numeric. Number of active chemotherapy orders. Weighted 3 points.
clozapine: Numeric. Number of Clozapine orders. Weighted 3 points.
digoxin: Numeric. Number of Digoxin orders. Weighted 3 points.
ganciclovir_valganciclovir: Numeric. Number of Ganciclovir/Valganciclovir orders. Weighted 1 point.
hyperosmolar_fluids: Numeric. Number of hyperosmolar fluid orders (Mannitol, Hypertonic Saline). Weighted 1 point.
immunosuppressants: Numeric. Number of immunosuppressant orders (e.g., Tacrolimus, Cyclosporine). Weighted 3 points.
lidocaine_infusion: Numeric. Number of Lidocaine infusion orders. Weighted 2 points.
lithium: Numeric. Number of Lithium orders. Weighted 3 points.
prostacyclins: Numeric. Number of Prostacyclin orders (e.g., Epoprostenol). Weighted 2 points.
theophylline: Numeric. Number of Theophylline orders. Weighted 3 points.
therapeutic_heparins: Numeric. Number of therapeutic heparin/enoxaparin orders. Weighted 2 points.
vancomycin_iv: Numeric. Number of IV Vancomycin orders. Weighted 3 points.
warfarin: Numeric. Number of Warfarin orders. Weighted 3 points.
thromboembolic_prophylaxis: Numeric (0 or 1). Presence of VTE prophylaxis. Weighted 1 point.
stress_ulcer_prophylaxis: Numeric (0 or 1). Presence of stress ulcer prophylaxis. Weighted 1 point.
glycemic_control: Numeric (0 or 1). Presence of glycemic control regimen (insulin). Weighted 1 point.
bowel_regimen: Numeric (0 or 1). Presence of bowel regimen. Weighted 1 point.
chlorhexidine: Numeric (0 or 1). Use of Chlorhexidine. Weighted 1 point.
inhalers_nebulizers: Numeric (0 or 1). Use of inhalers or nebulizers. Weighted 1 point.
continuous_sedation: Numeric (0 or 1). Continuous sedation infusion. Weighted 2 points.
continuous_vasopressors: Numeric. Number of continuous vasopressor infusions. Weighted 3 points each.
continuous_inotropes: Numeric. Number of continuous inotrope infusions. Weighted 3 points each.
continuous_nmba: Numeric. Number of continuous NMBA infusions. Weighted 3 points each.
continuous_iv_fluids: Numeric (0 or 1). Continuous IV fluids. Weighted 1 point.
parenteral_nutrition: Numeric (0 or 1). TPN/PPN use. Weighted 3 points.
fluid_bolus: Numeric (0 or 1). Fluid bolus administration. Weighted 1 point.
renal_replacement_therapy: Numeric (0 or 1). RRT/Dialysis. Weighted 3 points.
mechanical_ventilation: Numeric (0 or 1). Mechanical ventilation. Weighted 3 points.

References

Sikora A, Awdishu L, Palmer H, et al. Validation of the Medication Regimen Complexity-ICU (MRC-ICU) Score.

Examples

Run this code

# Example 1: High Complexity
# Vancomycin (3), Norepinephrine (3), Vent (3), Sedation (2)
mrc_icu_score(vancomycin_iv = 1, continuous_vasopressors = 1,
              mechanical_ventilation = 1, continuous_sedation = 1)

# Example 2: Low Complexity
# Prophylaxis only (VTE 1, Ulcer 1, Bowel 1)
mrc_icu_score(thromboembolic_prophylaxis = 1, stress_ulcer_prophylaxis = 1,
              bowel_regimen = 1)

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