phoenix (version 1.1.3)

phoenix: The Phoenix Sepsis Score

Description

The diagnostic Phoenix Sepsis Criteria based on four organ dysfunction scores, respiratory, cardiovascular, coagulation, and neurologic. A score of 2 or more indicates sepsis.

Usage

phoenix(
  pf_ratio,
  sf_ratio,
  imv,
  other_respiratory_support,
  vasoactives,
  lactate,
  map,
  platelets,
  inr,
  d_dimer,
  fibrinogen,
  gcs,
  fixed_pupils,
  age,
  data = parent.frame(),
  ...
)

Value

A data.frame with seven columns:

1. phoenix_respiratory_score

2. phoenix_cardiovascular_score

3. phoenix_coagulation_score

4. phoenix_neurologic_score

5. phoenix_sepsis_score

6. phoenix_sepsis An integer vector, 0 = not septic, 1 = septic (score greater or equal to 2)

7. phoenix_septic_shock An integer vector, 0 = not septic shock, 1 = septic shock (score greater or equal 2 and cardiovascular dysfunction)

As with all other Phoenix organ system scores, missing values in the data set will map to a score of zero - this is consistent with the development of the criteria.

Arguments

pf_ratio

numeric vector for the PaO2/FiO2 ratio; PaO2 = arterial oxygen pressure; FiO2 = fraction of inspired oxygen; PaO2 is measured in mmHg and FiO2 is from 0.21 (room air) to 1.00.

sf_ratio

numeric vector for the SpO2/FiO2 ratio; SpO2 = oxygen saturation, measured in a percent; ratio for 92% oxygen saturation on room air is 92/0.21 = 438.0952.

imv

invasive mechanical ventilation; numeric or integer vector, (0 = not intubated; 1 = intubated)

other_respiratory_support

other respiratory support; numeric or integer vector, (0 = no support; 1 = support)

vasoactives

an integer vector, the number of systemic vasoactive medications being administered to the patient. Six vasoactive medications are considered: dobutamine, dopamine, epinephrine, milrinone, norepinephrine, vasopressin.

lactate

numeric vector with the lactate value in mmol/L

map

numeric vector, mean arterial pressure in mmHg

platelets

numeric vector for platelets counts in units of 1,000/uL (thousand per microliter)

inr

numeric vector for the international normalised ratio blood test

d_dimer

numeric vector for D-Dimer, units of mg/L FEU

fibrinogen

numeric vector units of mg/dL

gcs

integer vector; total Glasgow Coma Score

fixed_pupils

integer vector; 1 = bilaterally fixed pupil, 0 = otherwise

age

numeric vector age in months

data

a list, data.frame, or environment containing the input vectors

...

pass through

Details

The details of each of the four component scores are found in their respective help files.

References

See reference details in phoenix-package or by calling citation('phoenix').

See Also

• phoenix for generating the diagnostic Phoenix Sepsis score based on the four organ systems:

  • phoenix_cardiovascular,

  • phoenix_coagulation,

  • phoenix_neurologic,

  • phoenix_respiratory,

• phoenix8 for generating the diagnostic Phoenix 8 Sepsis criteria based on the four organ systems noted above and

  • phoenix_endocrine,

  • phoenix_immunologic,

  • phoenix_renal,

  • phoenix_hepatic,

vignette('phoenix') for more details and examples.

Examples

# Using the example sepsis data set, read more details in the vignette

phoenix_scores <-
  phoenix(
    # Respiratory
      pf_ratio = pao2 / fio2,
      sf_ratio = ifelse(spo2 <= 97, spo2 / fio2, NA_real_),
      imv = vent,
      other_respiratory_support = as.integer(fio2 > 0.21),
    # Cardiovascular
      vasoactives = dobutamine + dopamine + epinephrine + milrinone + norepinephrine + vasopressin,
      lactate = lactate,
      age = age,
      map = dbp + (sbp - dbp)/3,
    # Coagulation
      platelets = platelets,
      inr = inr,
      d_dimer = d_dimer,
      fibrinogen = fibrinogen,
    # Neurologic
      gcs = gcs_total,
      fixed_pupils = as.integer(pupil == "both-fixed"),
    data = sepsis
  )

str(phoenix_scores)