Comparing Time-Fixed Mortality Prediction Models and Their Effect on ICU Performance Metrics Using the Simplified Acute Physiology Score 3

Abstract

The recalibrated Simplified Acute Physiology Score 3 hospital outcome prediction model performed well on long-term outcomes. Evaluation of ICU performance using standardized mortality ratio was only modestly sensitive to the follow-up time. Our results suggest that 30-day mortality may be a good benchmark of ICU performance. However, the duration of follow-up must balance between what is most relevant for patients, most affected by ICU care, least affected by administrative policies and practically feasible for caregivers.

The Impact of Implementing an Intensivist Model With Nighttime In-Hospital Nocturnist and Effect on ICU Outcomes

“…Second, the calibration and adjustment in the APACHE database over the duration of the study and variation in the patients' diagnoses in the ICU may affect the outcome prediction of the model. 34,35 The case mix adjuster in the APACHE system remained stable, suggesting that the patient variation did not significantly change over the 9-year time frame of data collection. The APACHE methods for adjusting for nonnormally distributed data are beyond the scope of this analysis and we are reporting mean values of the O/E LOS days pursuant to their standard reporting methods.…”

Prolonged Elevated Heart Rate and 90-Day Survival in Acutely Ill Patients: Data From the MIMIC-III Database

“…We a priori decided on 90-day survival status as the outcome because we believe it is more meaningful than in-hospital mortality and not too long to be dominated by underlying nonacute disease states. 10 In addition, survival status was available at 90 days.…”

Mortality after Severe Sepsis and Septic Shock in Swedish Intensive Care Units 2008‐2016—A nationwide observational study

“…Prior studies from the Swedish Intensive Care Registry (SIR) have demonstrated the feasibility to capture long-term outcomes with minimal loss to follow-up. 12,13 Hence, we set out to investigate whether mortality up to one year among critically ill patients with severe sepsis has changed from 2008 to 2016 and also to study the nonsepsis ICU population for comparison. Additionally, we wanted to investigate if patient demographics and comorbidity have changed over the same period, and whether these factors were associated with mortality.…”