2017-09-12 15:44:46

Hi Julie,

Pharmacy has Lab calculate this automatically so that the system has what we in pharmacy want... It is a bit much... What's CCIC? RAD uses their own ordinary CrCL calculator off the web I think if the patient hasn't had any recent labs that would cause this calculation below to trigger. Pharmacy works off of this result, as well as OE/POM. Of course pharmacy does a more unique calculation when patient variables become critical (amputations, etc.)

Hope it helps!

Andrew Ventura, Pharm.D, MBA

Pharmacy Informaticist, Information Systems

Augusta Health, Fishersville VA

C/S 5.67pp25

;Custom formulas for returning estimated CrCL automatically upon result

; of an SCr. Cockcroft-gault for adults with weight modifications per pharmacy

; Schwarts original for babies less than one year old, and Schwartz revised

; for children 1yo to age 18. Please see Andrew Ventura in Pharmacy/IT with

; any concerns.

; Cockcroft-Gault CrCl = (140-age) * (Wt in kg) * (0.85 if female) / (72 * Cr)

;

; Per discussion with Clinical Pharmacy Supervisor, patients with no height or no weight should return

; no value at all, so pharmacy does a more thorough review of renal fxn. Same

; for patients < 60" tall.

;

; Note: Since we are using an IDMS traceable assay for SCR

; we can use this formula for kids 1-18, not the complex one:

; GFR = (0.413 * HTCM)/SCr

;

; Notes below apply to the code line below each comment.

; ------------------------

;filter out non numeric CRE values.

CRE?0D^CRET,

;store the current age, height, weight, sex to variables,

[f pt cur age]^AGE,

[f pt oe wt kg]^WTKG,

[f pt oe ht cm]^HTCM,

[f pt sex]^SEX,

;Store K value factor for child age and sex.

IF{L(AGE,"D")'=L(AGE) 1^BABY},

IF{BABY=1 0.45}^KVAL,

;Store gender factors for formulas for CrCL and IBW.

IF{SEX="M" "1";"0.85"}^SCC,

IF{SEX="M" "50";"45.5"}^SIBW,

;If 65 or greater and CRET<1.0, assume 1.0, if <65 and CRET<0.8, assume 0.8

IF{(CRET<1.0)&(AGE'<65) "1";(CRET<0.8)&(AGE<65) "0.8";CRET}^CC,

;convert height to inches

HTCM/2.54^HTIN,

;calc IBW

SIBW+(2.3*(HTIN-60))^IBW,

;flag for if pt less than 60" tall

HTIN<60^AHT,

;flag for if pts weight is less than IBW

WTKG<IBW^AWT,

; check to see if patient is greater than 30% above IBW, if so, use Adj Wt form

IF{((WTKG/IBW)'<1.3) (IBW+(0.4*(WTKG-IBW)))^ADJWT},

;if the patient is not eligible for IBW,use actual,if adjwt exists, use it,

; otherwise use IBW

IF{AHT!AWT WTKG;ADJWT_.'=. ADJWT;IBW}^PTWT,

; If using adjusted weight, make result 4 decimals, otherwise make it 2.

IF{ADJWT_.'=. 1.0000;1.000000}^LIM,

;Do the formula! Hooray!

((140-AGE):10D*PTWT:10D*SCC:10D)/(72*CC)^RES,

;if 1-<18 years old, use this formula instead:(revised schwartz)

((0.413*HTCM)/(CRET))^PEDSRES,

;do the original schwartz formula for babies < 1 yr old too

((KVAL*HTCM)/(CRET)):2D^BABYRES,

;don't result anything if the height or weight is missing or pt <18yo.

;the FV was added by Jeanne in lab, I believe to make it flow through the

;lab analyzers or interfaces.

IF{HTCM_.=. [f lres no prt];WTKG_.=. [f lres no prt];

(AGE<18)&(BABY=1) BABYRES;AGE<18 PEDSRES;

HTCM<152.4 [f lres no prt];

RES/LIM}_"FV";