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)

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)

Cardiovascular

Renal

Pulmonary (Ventilated Patients Only)

Hematologic

Hepatic

Critical Implementation Notes

1. Prothrombin Time (PT): The "standard" PT is assumed to be 12 seconds. Abnormal is > 15s (12 + 3) or < 3s (12 * 0.25).

2. Pulmonary Scoring: Only scored for patients on mechanical ventilation or CPAP. Non-ventilated patients get 0.

3. CPAP Detection: Identified from oxygen delivery device documentation containing "cpap" or "bipap mask".

4. GCS < 3: Treated as null (erroneous value or tracheostomy).

5. 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.