Number | Variable | Values | Yes (M + O) N (%) | No N (%) | ||
---|---|---|---|---|---|---|
1-Personal Information, all are Mandatory | ||||||
 1–1 | Medical Record number | Number | 7 (87.50) | 1 (12.50) | ||
 1–2 | National code | Number | 8 (100) | 0 (0) | ||
 1–3 | Age | Number | 8 (100) | 0 (0) | ||
 1–4 | Sex | Male/Female/ Unknown | 8 (100) | 0 (0) | ||
 1–5 | First name | Text | 6 (75) | 2 (25) | ||
 1–6 | Last name | Text | 6 (75) | 2 (25) | ||
 1–7 | Father's name | Text | 6 (75) | 2 (25) | ||
 1–8 | Birth date | YYYY/MM/DD | 6 (75) | 2 (25) | ||
 1–9 | Estimated height | Number | 6 (75) | 2 (25) | ||
 1–10 | Estimated weight | Number | 6 (75) | 2 (25) | ||
2-Admission Details, all are Mandatory | ||||||
 2–1 | Date of admission to hospital | YYYY/MM/DD | 6 (75) | 2 (25) | ||
 2–2 | Time of admission to hospital | HH:MM | 6 (75) | 2 (25) | ||
 2–3 | Date of admission to ICU | YYYY/MM/DD | 6 (75) | 2 (25) | ||
 2–4 | Time of admission to ICU | HH:MM | 6 (75) | 2 (25) | ||
 2–5 | Admission type | Medical 0 / Surgical 1 | 8 (100) | 0 (0) | ||
 2–6 | Surgical admission | Elective 0 / Emergency 1 | 8 (100) | 0 (0) | ||
 2–7 | Insurance coverage | No/Yes | 6 (75) | 2 (25) | ||
 2–8 | Primary diagnosis | Text/Code | 8 (100) | 0 (0) | ||
 2–9 | ICU diagnosis | Non-operative 0 / Post-operative 1 | 8 (100) | 0 (0) | ||
 2–10 | ICU intervention | Invasive ventilation 0 | 8 (100) | 0 (0) | ||
Non-invasive ventilation 1 | ||||||
tracheostomy 2 | ||||||
ECMO 3 | ||||||
Renal replacement therapy 4 | ||||||
Inotropes/Vasopressor drug 5 | ||||||
Other 6 | ||||||
None 7 | ||||||
3-Present illness: | ||||||
 3–1-Respiratory disease | ||||||
  3–1-1 | Pneumonia | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-2 | Pleural effusion | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-3 | Pneumothorax | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-4 | Profound hypoxemia | No/Yes | O | 8 (100) | 0 (0) | |
  3–1-5 | Respiratory aspiration | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-6 | Hemothorax | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-7 | Bronchitis | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-8 | ARDS | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-9 | Pulmonary Embolism | No/Yes | M | 8 (100) | 0 (0) | |
  3–1-10 | Post hypercapnic state | No/Yes | M | 8 (100) | 0 (0) | |
 3–2-Renal disease | ||||||
  3–2-1 | Acute Kidney injury | No/Yes | M | 8 (100) | 0 (0) | |
  3–2-2 | Myoglobinuric acute renal failure | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–2-3 | Uremia | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–2-4 | Renal failure plus alkali therapy | No/Yes | O | 6 (75) | 2 (25) | |
  3–2-5 | Obstructive nephropathy | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–2-6 | Renal transplant rejection | No/Yes | O | 8 (100) | 0 (0) | |
 3–3-Gastrointestinal disease/ Liver disease | ||||||
  3–3-1 | Acute hepatic failure | No/Yes | M | 8 (100) | 0 (0) | |
  3–3-2 | Ischemic bowel | No/Yes | M | 8 (100) | 0 (0) | |
  3–3-3 | Small bowel obstruction | No/Yes | M | 8 (100) | 0 (0) | |
  3–3-4 | Diarrhea | No/Yes | M | 8 (100) | 0 (0) | |
  3–3-5 | Vomiting | No/Yes | M | 8 (100) | 0 (0) | |
  3–3-6 | Gastric aspiration | No/Yes | M | 8 (100) | 0 (0) | |
 3–4-Endocrine disease | ||||||
  3–4-1 | Diabetic Ketoacidosis (acetoacetate) | No/Yes | M | 8 (100) | 0 (0) | |
  3–4-2 | Late stage in treatment of diabetic ketoacidosis | No/Yes | M | 8 (100) | 0 (0) | |
  3–4-3 | Hyperalbuminemia | No/Yes | O | 8 (100) | 0 (0) | |
  3–4-4 | Hypercalcemia- hypoparathyroidism | No/Yes | O | 8 (100) | 0 (0) | |
  3–4-5 | Cushing disease | No/Yes | O | 6 (75) | 2 (25) | |
  3–4-6 | Adrenal disease | No/Yes | O | 8 (100) | 0 (0) | |
  3–4-7 | Idiopathic hypercalciuria | No/Yes | O | 6 (75) | 2 (25) | |
 3–5-Cardiovascular disease | ||||||
  3–5-1 | Shock | No 0 | M | 8 (100) | 0 (0) | |
Septic shock 1 | ||||||
Hypovolemic shock 2 | ||||||
Cardiogenic shock 3 | ||||||
Hemorrhagic shock 4 | ||||||
Obstructive shock 5 | ||||||
Other shock 6 | ||||||
  3–5-2 | Accelerated hypertension | No/Yes | M | 8 (100) | 0 (0) | |
  3–5-3 | Cardiac failure | No/Yes | M | 8 (100) | 0 (0) | |
 3–6-Hematologic disease | ||||||
  3–6-1 | Paroxysmal nocturnal hemoglobinuria | No/Yes | O | 6 (75) | 2 (25) | |
  3–6-2 | Hyperglobulinemic purpura | No/Yes | O | 6 (75) | 2 (25) | |
 3–7-Neurologic disease | ||||||
  3–7-1 | Active seizure | No/Yes | M | 8 (100) | 0 (0) | |
  3–7-2 | Recent CVA | No/Yes | M | 8 (100) | 0 (0) | |
  3–7-3 | CNS infections | No/Yes | M | 8 (100) | 0 (0) | |
  3–7-4 | Encephalitis | No/Yes | M | 8 (100) | 0 (0) | |
  3–7-5 | Meningitis | No/Yes | M | 8 (100) | 0 (0) | |
  3–7-6 | Muscular dystrophy | No/Yes | O | 7 (87.50) | 1 (12.50) | |
 3–8-Infectious disease | ||||||
  3–8-1 | Sepsis | No/Yes | M | 8 (100) | 0 (0) | |
  3–8-2 | Cholera | No/Yes | O | 6 (75) | 2 (25) | |
  3–8-3 | Acute Poliomyelitis | No/Yes | O | 7 (87.50) | 1 (12.50) | |
 3–9-Trauma | ||||||
  3–9-1 | Heat exposure | No/Yes | O | 8 (100) | 0 (0) | |
  3–9-2 | High altitude | No/Yes | O | 8 (100) | 0 (0) | |
  3–9-3 | Barotrauma | No/Yes | O | 8 (100) | 0 (0) | |
  3–9-4 | Acute starvation | No/Yes | M | 8 (100) | 0 (0) | |
  3–9-5 | Rhabdomyolysis | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–9-6 | Severe trauma | No/Yes | M | 8 (100) | 0 (0) | |
 3–10-Drugs | ||||||
  3–10-1 | Diuretics | No 0 | M | 8 (100) | 0 (0) | |
Thiazide 1 | ||||||
Acetazolamide 2 | ||||||
Furosemide 3 | ||||||
Triamterene 4 | ||||||
Spironolactone 5 | ||||||
Other 6 | ||||||
  3–10-2 | Calcium chloride | No/Yes | O | 8 (100) | 0 (0) | |
  3–10-3 | Magnesium sulfate | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-4 | Cholestyramine | No/Yes | O | 8 (100) | 0 (0) | |
  3–10-5 | Paraldehyde | No/Yes | B | 8 (100) | 0 (0) | |
  3–10-6 | Sorbitol | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-7 | Angiotensin-converting enzyme inhibitors (ACE inhibitors) | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-8 | angiotensin 2 receptor blockers (ARBs) | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-9 | Digoxin /digitalis | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-10 | Beta adrenergic antagonist | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-11 | α adrenergic agonists | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-12 | Somatostatine | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-13 | Diazoxide | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-15 | Arginine hydrochloride | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-16 | Lysine hydrochloride | No/Yes | O | 5 (62.50) | 3 (37.50) | |
  3–10-17 | Acute alkali administration | No/Yes | O | 8 (100) | 0 (0) | |
  3–10-18 | Kayeoxalate | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-19 | Fludrocortisone | No/Yes | O | 8 (100) | 0 (0) | |
  3–10-20 | Combined administration of sodium polystyrene sulfonate (kayexalate and aluminum hydroxide) | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-21 | Penicillin (Non reabsorbable anions) | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-22 | Carbenicillin (Non reabsorbable anions) | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-23 | Bumetanide | No/Yes | M | 6 (75) | 2 (25) | |
  3–10-24 | Nonsteroidal anti-inflammatory drugs (NSAIDs) | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-25 | Cyclosporine | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-26 | IV xylose | No/Yes | O | 6 (75) | 2 (25) | |
  3–10-27 | IV sorbitol | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-28 | Ethanol | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-29 | Ifosfamide | No/Yes | O | 6 (75) | 2 (25) | |
  3–10-30 | Amphotericin B | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-31 | Foscarnet | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-32 | Streptozotocin | No/Yes | O | 6 (75) | 2 (25) | |
  3–10-33 | Amiloride | No/Yes | O | 6 (75) | 2 (25) | |
  3–10-35 | Trimethoprim | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-36 | Tacrolimus | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-37 | Intravenous (IV) fructose | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-38 | Methenamin Hippurate | No/Yes | O | 6 (75) | 2 (25) | |
  3–10-39 | Ammonium chloride | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-40 | Total parental nutrition (TPN) | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-41 | rapid saline administration | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-42 | Nonnucleoside antireverse transcriptase drugs | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-43 | sulfanilamide | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–10-44 | Mafenide acetate | No/Yes | B | 7 (87.50) | 1 (12.50) | |
  3–10-45 | Lithium | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-46 | Heparin (low MW or unfractionated) in critical ill patients | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-47 | Carbenoxolone | No/Yes | O | 6 (75) | 2 (25) | |
  3–10-48 | Estrogen | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-49 | Bicarbonate therapy of organic acidosis | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-50 | Morphine | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-51 | Sedative | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–10-52 | Renin angiotensin system modulating agents(ACEI, ARB) | No/Yes | M | 5 (62.50) | 3 (37.5) | |
  3–10-53 | Mannitol | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-54 | Metformin | No/Yes | M | 8 (100) | 0 (0) | |
  3–10-55 | Glucocorticoid | No/Yes | M | 6 (75) | 2 (25) | |
  3–10-56 | Ectopic corticotropin | No/Yes | O | 6 (75) | 2 (25) | |
 3–11-Toxins | ||||||
  3–11-1 | Methanol | No/Yes | M | 8 (100) | 0 (0) | |
  3–11-2 | Ethanol | No/Yes | M | 8 (100) | 0 (0) | |
  3–11-3 | Ethylene glycol | No/Yes | O | 8 (100) | 0 (0) | |
  3–11-4 | Propylene glycol | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-5 | Isopropyl alcohol poisoning | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-6 | Acetone poisoning | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-7 | Methyl alcohol | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-8 | Salicylate intoxication | No/Yes | M | 8 (100) | 0 (0) | |
  3–11-9 | Paraldehyde | No/Yes | O | 8 (100) | 0 (0) | |
  3–11-10 | Toluene | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-11 | Pyroglutamic (5-oxoproline) | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-12 | Cyanide | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  3–11-13 | 2,4 dinitrophenol | No/Yes | O | 6 (75) | 2 (25) | |
  3–11-14 | Carbon monoxide poisoning | No/Yes | O | 8 (100) | 0 (0) | |
  3–11-15 | Lead | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  3–11-16 | Vitamin D toxicity | No/Yes | O | 6 (75) | 2 (25) | |
  3–11-17 | Outdated Tetracycline | No/Yes | O | 6 (75) | 2 (25) | |
  3–11-18 | Sulfur ingestion | No/Yes | O | 6 (75) | 2 (25) | |
  3–11-19 | NH4CI ingestion | No/Yes | O | 6 (75) | 2 (25) | |
  3–11-20 | Alcohols metabolized by alcohol dehydrogenase | No/Yes | M | 6 (75) | 2 (25) | |
  3–11-21 | Methicillin nephrotoxicity | No/Yes | O | 6 (75) | 2 (25) | |
4-Past Medical History: | ||||||
 4–1-Respiratory disease | ||||||
  4–1-1 | COPD | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  4–1-2 | Asthma (severe) | No/Yes | M | 8 (100) | 0 (0) | |
  4–1-3 | Other obstructive lung disease | No/Yes | O | 8 (100) | 0 (0) | |
  4–1-4 | Sleep disorder breathing (OSA or OHS) | No/Yes | M | 8 (100) | 0 (0) | |
  4–1-5 | Pleural effusion | No/Yes | M | 8 (100) | 0 (0) | |
  4–1-6 | Pneumoconiosis | No/Yes | O | 8 (100) | 0 (0) | |
  4–1-7 | Emphysema | No/Yes | M | 8 (100) | 0 (0) | |
  4–1-8 | Cystic fibrosis | No/Yes | O | 8 (100) | 0 (0) | |
  4–1-9 | Fibrosing alveolitis | No/Yes | O | 8 (100) | 0 (0) | |
 4–2-Renal disease | ||||||
  4–2-1 | Chronic kidney disease | No/Yes | M | 8 (100) | 0 (0) | |
  4–2-2 | ESRD | No/Yes | M | 8 (100) | 0 (0) | |
  4–2-3 | Nephrosclerosis | No/Yes | O | 6 (75) | 2 (25) | |
  4–2-4 | Bartter syndrome | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–2-5 | Gitelmans syndrome | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–2-6 | Renal artery stenosis | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–2-7 | Liddles syndrome | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–2-8 | Balkan nephropathy | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–2-9 | Nephrocalcinosis | No/Yes | O | 6 (75) | 2 (25) | |
  4–2-10 | HIV nephropathy | No/Yes | O | 5 (62.50) | 3 (37.50) | |
  4–2-11 | Chronic pyelonephritis | No/Yes | M | 7 (87.50) | 1 (12.50) | |
  4–2-12 | Medullary cystic disease | No/Yes | O | 6 (75) | 2 (25) | |
  4–2-13 | Renal transplantation | No/Yes | M | 8 (100) | 0 (0) | |
  4–2-14 | Nephrotic syndrome | No/Yes | M | 8 (100) | 0 (0) | |
  4–2-15 | Diabetic nephropathy | No/Yes | M | 8 (100) | 0 (0) | |
  4–2-16 | Tubulointerstitial nephropathies | No/Yes | M | 5 (62.50) | 3 (37.50) | |
  4–2-17 | Lupus nephritis | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–2-18 | Obstructive nephropathy | No/Yes | M | 7 (87.50) | 1 (12.50) | |
 4–3-Gastrointestinal disease/ Liver disease | ||||||
  4–3-1 | Chronic liver failure/Cirrhosis | No/Yes | M | 8 (100) | 0 (0) | |
  4–3-2 | Short bowel syndrome | No/Yes | O | 8 (100) | 0 (0) | |
  4–3-3 | Fistula, Enteral/external (external pancreatic or small bowel drainage, uterosigmoidostomy, jejunal loop) | No/Yes | O | 8 (100) | 0 (0) | |
  4–3-4 | Villous adenoma | No/Yes | O | 5 (62.50) | 3 (37.50) | |
  4–3-5 | Ileostomy | No/Yes | M | 5 (62.50) | 3 (37.50) | |
  4–3-6 | Jejunoileal bypass with hyperoxaluria | No/Yes | O | 8 (100) | 0 (0) | |
  4–3-7 | Jejunal bypass with hyperoxaluria | No/Yes | O | 7 (87.50) | 1 (12.50) | |
 4–4-Endocrine disease | ||||||
  4–4-1 | Hyperthyroidism | No/Yes | M | 8 (100) | 0 (0) | |
  4–4-2 | Diabetes mellitus | No/Yes | M | 8 (100) | 0 (0) | |
  4–4-3 | Pheochromocytoma | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-4 | Addison disease | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-5 | Bilateral adrenalectomy | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-6 | Hypercalcemia- hypoparathyroidism | No/Yes | M | 8 (100) | 0 (0) | |
  4–4-7 | Milk – alkali syndrome | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-8 | Renin secreting tumor | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-9 | Primary aldosteronism | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-10 | Familial hypoaldosteronism | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–4-11 | Chronic idiopathic hypoaldosteronism | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–4-12 | Desmolase deficiency | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–4-13 | Adrenal carcinoma/adenoma | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-14 | Adrenal hyperplasia | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–4-15 | Adrenal destruction | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-16 | Primary pituitary adenoma | No/Yes | O | 6 (75) | 2 (25) | |
  4–4-17 | Conn’s syndrome | No/Yes | O | 5 (62.50) | 3 (37.50) | |
  4–4-18 | Idiopathic hypercalciuria | No/Yes | O | 5 (62.50) | 3 (37.50) | |
  4–4-19 | Primary hyperparathyroidism | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–4-20 | Secondary hyperparathyroidism with chronic hypocalcemia:Vitamin D deficiency or resistance | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-21 | Secondary hyperparathyroidism with chronic hypocalcemia:Vitamin D dependency | No/Yes | O | 8 (100) | 0 (0) | |
  4–4-22 | Hyperaldosteronism | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–4-23 | Hyperreninemia | No/Yes | O | 6 (75) | 2 (25) | |
  4–4-24 | Obesity | No/Yes | O | 5 (62.50) | 3 (37.50) | |
 4–5-Cardiovascular disease | ||||||
  4–5-1 | Cardiac failure | No/Yes | M | 8 (100) | 0 (0) | |
 4–6-Hematologic disease | ||||||
  4–6-1 | Hereditary elliptocytosis | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–6-2 | Sickle cell anemia | No/Yes | O | 8 (100) | 0 (0) | |
  4–6-3 | Multiple myeloma | No/Yes | O | 8 (100) | 0 (0) | |
  4–6-4 | Profound anemia | No/Yes | M | 8 (100) | 0 (0) | |
  4–6-5 | Paroxysmal nocturnal hemoglobinouria | No/Yes | O | 6 (75) | 2 (25) | |
 4–7-Neurologic disease | ||||||
  4–7-1 | CVA | No/Yes | M | 8 (100) | 0 (0) | |
  4–7-2 | CNS tumors | No/Yes | M | 8 (100) | 0 (0) | |
  4–7-3 | Myasthenia gravis | No/Yes | M | 8 (100) | 0 (0) | |
  4–7-4 | Multiple Schlerosis | No/Yes | M | 8 (100) | 0 (0) | |
  4–7-5 | Neuroblastoma | No/Yes | O | 6 (75) | 2 (25) | |
 4–8-Genetic/Congenital disorders | ||||||
  4–8-1 | Congenital chloridorrhea | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–8-2 | Fanconi syndrome | No/Yes | O | 5 (62.50) | 3 (37.50) | |
  4–8-3 | Pseudohypoaldosteronism-1 (PHA-1) | No 0 | O | 6 (75) | 2 (25) | |
autosomal dominant 1 | ||||||
Autosomal recessive 2 | ||||||
  4–8-4 | Pseudohypoaldosteronism-2 (PHA-2) | No | O | 6 (75) | 2 (25) | |
Autosomal dominant 1 | ||||||
  4–8-5 | Inborn errors of metabolism | No/Yes | O | 8 (100) | 0 (0) | |
  4–8-6 | Coricosterone methyloxidase deficiency | No 0 | O | 6 (75) | 2 (25) | |
type I 1 | ||||||
Type II 2 | ||||||
  4–8-7 | Primary zona glomerulosa defect | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-8 | Transient hypoaldosteronism of infancy | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-9 | Galactosemia | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–8-10 | Hereditary fructose intolerance | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–8-11 | Metachromatic leukodystrophy | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-12 | Pyruvate carboxylase deficiency | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–8-13 | Methylmalonic acidemia | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–8-14 | Fabry disease | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-15 | Carnitine palmitoyltransferase | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-16 | Carbonic anhydrase 2 deficiency with osteopetrosis (Sly syndrome) | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-17 | 21 hydroxylase deficiency | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-18 | 3 beta –hydroxydehrogenase deficiency | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-19 | Hereditary (Congenital) sensorineural deafness | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-20 | Carbonic anhydrase deficiency or inhibition | No/Yes | O | 6 (75) | 2 (25) | |
  4–8-21 | Tyrosinemia | No/Yes | O | 6 (75) | 2 (25) | |
 4–9-Infectious disease | ||||||
  4–9-1 | Acquired immunodeficiency syndrome | No/Yes | O | 5 (62.50) | 3 (37.50) | |
 4–10-Rheumatology/musculoskeletal disease | ||||||
  4–10-1 | polyarteritis nodosa | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–10-2 | Sjögren's syndrome | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–10-3 | Kyphoscoliosis | No/Yes | O | 7 (87.50) | 1 (12.50) | |
  4–10-4 | Muscular dystrophies | No/Yes | O | 7 (87.50) | 1 (12.50) | |
 4–11- Malignancy (b) | 8 (100) | 0 (0) | ||||
5-Societal status | ||||||
 5–1 | Opioid dependency | No/Yes | M | 8 (100) | 0 (0) | |
 5–2 | Chronic alcohol use | No/Yes | M | 8 (100) | 0 (0) | |
 5–3 | Sedatives dependency | No/Yes | M | 8 (100) | 0 (0) | |
 5–4 | Tobacco chewer | No/Yes | M | 6 (75) | 2 (25) | |
6-Physical examination | ||||||
 6–1-Vital signs | ||||||
  6–1-1 | Last body temperature | M | 8 (100) | 0 (0) | ||
  6–1-2 | Last systolic blood pressure | M | 8 (100) | 0 (0) | ||
  6–1-3 | Last diastolic blood pressure | M | 8 (100) | 0 (0) | ||
  6–1-4 | Last MAP (mean arterial pressure) | M | 8 (100) | 0 (0) | ||
  6–1-5 | Heart rate (beat per minute) | M | 8 (100) | 0 (0) | ||
  6–1-6 | Last total respiratory rate | M | 8 (100) | 0 (0) | ||
  6–1-7 | Last spO2 | M | 8 (100) | 0 (0) | ||
 6–2-GCS (physician note) | 8 (100) | 0 (0) | ||||
 6–3-Respiratory: | ||||||
  6–3-1 | Spontaneous breathing (FiO2%) | M | 8 (100) | 0 (0) | ||
  6–3-2 | Assisted (FiO2%) | M | 8 (100) | 0 (0) | ||
  6–3-3 | PaO2/FiO2 Ratio | M | 8 (100) | 0 (0) | ||
  6–3-4 | Flail chest (Yes/No) | M | 8 (100) | 0 (0) | ||
 6–4- sedation status (RAS score) | M | 7 (87.50) | 1 (12.50) | |||
 6–5-Numeric pain scale | M | 8 (100) | 0 (0) | |||
 6–6-Behavioral Pain Score | M | 7 (87.50) | 1 (12.50) | |||
 6–7-Diaphoresis(Yes/No) | M | 8 (100) | 0 (0) | |||
 6–8-Shivering(Yes/No) | M | 7 (87.50) | 1 (12.50) | |||
 6–9-Cyanosis (if spO2 unavailable or suspicious) (Yes/No) | M | 8 (100) | 0 (0) | |||
 6–10-Urine output | M | 8 (100) | 0 (0) | |||
 6–11-Nasogastric drainage | M | 8 (100) | 0 (0) | |||
 6–12-Edematous states(Yes/No) | M | 8 (100) | 0 (0) | |||
 6–13-Poor tissue perfusion (regional hypo-perfusion) (Yes/No) | M | 8 (100) | 0 (0) | |||
7-Para-clinical investigation | ||||||
 7–1 | Last WBC | M | 7 (87.50) | 1 (12.50) | ||
 7–2 | Last Hb | M | 8 (100) | 0 (0) | ||
 7–3 | Last MetHb | O | 7 (87.50) | 1 (12.50) | ||
 7–4 | Last CarboxyHb | O | 7 (87.50) | 1 (12.50) | ||
 7–5 | Last plt | M | 6 (75) | 2 (25) | ||
 7–6 | Last Na | M | 8 (100) | 0 (0) | ||
 7–7 | Last K | M | 8 (100) | 0 (0) | ||
 7–8 | Last BUN | M | 8 (100) | 0 (0) | ||
 7–9 | Last Creatinin | M | 8 (100) | 0 (0) | ||
 7–10 | Urine for oxalate crystals (ethylene glycol) | O | 8 (100) | 0 (0) | ||
 7–11 | Last Mg | O | 8 (100) | 0 (0) | ||
 7–12 | Last Ca | O | 8 (100) | 0 (0) | ||
 7–13 | Last Cl | O | 8 (100) | 0 (0) | ||
 7–14 | Last Glucose | M | 8 (100) | 0 (0) | ||
 7–15 | Last Lactate | O | 8 (100) | 0 (0) | ||
 7–16 | Last Bilirubin | O | 6 (75) | 2 (25) | ||
 7–17 | Last Albumin | O | 8 (100) | 0 (0) | ||
 7–18 | Last Li+ | O | 7 (87.50) | 1 (12.50) | ||
 7–19 | Last sulfate | O | 6 (75) | 2 (25) | ||
 7–20 | Last phosphate | O | 8 (100) | 0 (0) | ||
 7–21 | Last IgG | O | 8 (100) | 0 (0) | ||
 7–22 | Hyperviscosity | O | 6 (75) | 2 (25) | ||
 7–24 | Thiamine (B1) level | O | 6 (62.50) | 3 (37.50) | ||
 7–25 | Anion Gap: | M | 8 (100) | 0 (0) | ||
 7–26 | Corrected Anion Gap | M | 8 (100) | 0 (0) | ||
 7–27 | Albumin Gap | M | 8 (100) | 0 (0) | ||
 7–28 | Osmolality measured | O | 8 (100) | 0 (0) | ||
 7–29 | Osmolality calculated | O | 8 (100) | 0 (0) | ||
 7–30 | Osmolar gap | O | 8 (100) | 0 (0) | ||
8-Blood gas parameter | ||||||
 8–1 | Last ABG | M | 8 (100) | 0 (0) | ||
 8–2 | pH | M | 8 (100) | 0 (0) | ||
 8–3 | pCO2 | M | 8 (100) | 0 (0) | ||
 8–4 | pO2 | M | 8 (100) | 0 (0) | ||
 8–5 | O2 saturation | M | 8 (100) | 0 (0) | ||
 8–6 | HCO3 | M | 8 (100) | 0 (0) | ||
 8–7 | Base Excess/base deficit | M | 8 (100) | 0 (0) | ||
9-SOFA score, all are mandatory | ||||||
 9–1 | PaO2/FiO2 (mmHg) | 8 (100) | 0 (0) | |||
 9–2 | GCS | 8 (100) | 0 (0) | |||
 9–3 | Mean arterial pressure (MAP) | 8 (100) | 0 (0) | |||
 9–4 | Bilirubin (mg/dl) [μmol/L] | 7 (87.50) | 1 (12.50) | |||
 9–5 | Platelets × 103/ml | 6 (75) | 2 (25) | |||
 9–6 | Creatinine (mg/dl) [μmol/L] | 8 (100) | 0 (0) | |||
10-Sampling technique (ABG Error), all are mandatory | ||||||
 10–1 | Steady state | No/Yes | 8 (100) | 0 (0) | ||
 10–2 | Anticoagulants (Excess) | No/Yes | 8 (100) | 0 (0) | ||
 10–3 | Processing delay | Number (Minute) | 8 (100) | 0 (0) | ||
 10–4 | Venous sampling: | No/Yes | 8 (100) | 0 (0) | ||
 10–5 | Acceptable pulse oximetry care | No/Yes | 8 (100) | 0 (0) | ||
 10–6 | SpO2 calculated by pulse oximetry | No/Yes | 8 (100) | 0 (0) | ||
 10–7 | Sampling equipment | Dead space: … (volume) | 8 (100) | 0 (0) | ||
Needle gauge ≥ 25: | ||||||
No 0 | ||||||
Yes 1 | ||||||
Needle size: | ||||||
25 | ||||||
35 | ||||||
 10–8 | Ventilator status | Mechanical ventilation 0 | 8 (100) | 0 (0) | ||
Non mechanical ventilation 1 | ||||||
 10–9 | Mode of ventilation and information on oxygen supply | According to admission/progress note | 8 (100) | 0 (0) | ||
 10–10 | Request for related measurements (electrolytes, metabolites) | yes/no | 8 (100) | 0 (0) | ||
 10–11 | Person collecting the sample | Novice | 8 (100) | 0 (0) | ||
Experienced | ||||||
 10–12 | CO Oximetry | No/Yes | 8 (100) | 0 (0) |