Calculate LODS (Logistic Organ Dysfunction Score) for ICU patients. Use for organ dysfunction assessment across 6 systems with weighted scoring.
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.
| System | Variables | Score Range |
|---|---|---|
| Neurologic | GCS | 0-5 |
| Cardiovascular | HR, SBP | 0-5 |
| Renal | BUN, Creatinine, Urine Output | 0-5 |
| Pulmonary |
| PaO2/FiO2 (ventilated only) |
| 0-3 |
| Hematologic | WBC, Platelets | 0-3 |
| Hepatic | PT, Bilirubin | 0-1 |
Total Range: 0-22
SELECT
subject_id,
hadm_id,
stay_id,
lods,
neurologic,
cardiovascular,
renal,
pulmonary,
hematologic,
hepatic
FROM mimiciv_derived.lods;
| GCS | Score |
|---|---|
| <= 5 | 5 |
| 6-8 | 3 |
| 9-13 | 1 |
| 14-15 | 0 |
| Condition | Score |
|---|---|
| HR < 30 OR SBP < 40 | 5 |
| SBP < 70 OR SBP >= 270 | 3 |
| HR >= 140 OR SBP >= 240 OR SBP < 90 | 1 |
| Normal | 0 |
| Condition | Score |
|---|---|
| UO < 500 OR BUN >= 56 | 5 |
| Cr >= 1.6 OR UO < 750 OR BUN >= 28 OR UO >= 10000 | 3 |
| Cr >= 1.2 OR BUN >= 7.5 | 1 |
| Normal | 0 |
| PaO2/FiO2 | Score |
|---|---|
| < 150 | 3 |
| >= 150 | 1 |
| Not ventilated | 0 |
| Condition | Score |
|---|---|
| WBC < 1.0 | 3 |
| WBC < 2.5 OR Platelets < 50 OR WBC >= 50 | 1 |
| Normal | 0 |
| Condition | Score |
|---|---|
| Bilirubin >= 2.0 OR PT > 15s OR PT < 3s | 1 |
| Normal | 0 |
Prothrombin Time (PT): The "standard" PT is assumed to be 12 seconds. Abnormal is > 15s (12 + 3) or < 3s (12 * 0.25).
Pulmonary Scoring: Only scored for patients on mechanical ventilation or CPAP. Non-ventilated patients get 0.
CPAP Detection: Identified from oxygen delivery device documentation containing "cpap" or "bipap mask".
GCS < 3: Treated as null (erroneous value or tracheostomy).
Missing Data: Missing components are imputed as 0 (normal).
Known Issue — BUN Threshold: The underlying MIMIC-Code SQL uses a BUN threshold of >= 7.5 mg/dL for renal Score 1. This does not match the original publication (Le Gall 1996, Table 5), which defines the Score 1 cutoff as BUN >= 17 mg/dL (= 6 mmol/L × 2.8). Values between 7.5 and 16.9 mg/dL should receive Score 0. This is likely a unit conversion error and has been flagged for correction upstream.
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;
-- 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;