Customised prediction models based on APACHE II and SAPS II scores in patients with prolonged length of stay in the ICU

Suistomaa, M.; Niskanen, Minna; Kari, A.; Hynynen, Markku; Takala, Jukka

doi:10.1007/s00134-002-1214-9

Cited by 49 publications

(48 citation statements)

References 18 publications

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“…The median duration of MV (7 days) was similar to that shown in international studies 28,29 : 5 to 7 days. However, IQRs differed greatly, probably due to the absolute lack of long-term acute care facilities in the state of Buenos Aires.…”

Section: Discussionsupporting

confidence: 76%

Shock on Admission Day Is the Best Predictor of Prolonged Mechanical Ventilation in the ICU

Bakker

González

Laffaire

et al. 2005

Chest

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Section: Discussionsupporting

confidence: 76%

Shock on Admission Day Is the Best Predictor of Prolonged Mechanical Ventilation in the ICU

Bakker

González

Laffaire

et al. 2005

Chest

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“…There are a number of possible reasons for this finding. First, APACHE II scores calculated at ICU admission have been shown to be less predictive of outcome in patients whose stays are prolonged [16], as in our study. Second, although complete data were available for all patients for almost all of the variables, daily SOFA scores were unavailable for 24 nonbleeding patients in the present study.…”

Section: Discussionmentioning

confidence: 64%

Untitled

2006

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“…This is probably related to case mix. The SAPS II score loses its predictive value for hospital outcome in patients requiring prolonged intensive care [36]. Furthermore, our sample included a relevant number of patients admitted after elective surgery, who were initially stable with low SAPS II scores, but whose stay in the ICU was prolonged due to complications developing later.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of a clinical diagnosis of ICU-acquired paresis to predict outcome in patients with SIRS and acute respiratory failure

et al. 2009

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Purpose: Neuromuscular abnormalities are common in ICU patients. We aimed to assess the incidence of clinically diagnosed ICU-acquired paresis (ICUAP) and its impact on outcome. Methods: Forty-two patients with systemic inflammatory response syndrome on mechanical ventilation for C48 h were prospectively studied. Diagnosis of ICUAP was defined as symmetric limb muscle weakness in at least two muscle groups at ICU discharge without other explanation. The threshold Medical Research Council (MRC) Score was set at 35 (of 50) points. Activities in daily living were scored using the Barthel Index 28 and 180 days after ICU discharge. Results: Three patients died before sedation was stopped. I-CUAP was diagnosed in 13 of the 39 patients (33%). Multivariate regression analysis yielded five ICU-AP-predicting variables (P \ 0.05): SAPS II at ICU admission, treatment with steroids, muscle relaxants or norepinephrine, and days with sepsis. Patients with ICUAP had lower admission SAPS II scores [37 ± 13 vs. 49 ± 15 (P = 0.018)], lower Barthel Index at 28 days and lower survival at 180 days after ICU discharge (38 vs. 77%, P = 0.033) than patients without ICUAP. Daily TISS-28 scores were similar but cumulative TISS-28 scores were higher in patients with ICUAP (664 ± 275) than in patients without ICUAP (417 ± 236; P = 0.008). The only independent risk factor for death before day 180 was the presence of ICUAP. Conclusions: A clinical diagnosis of ICUAP was frequently established in this patient group. Despite lower SAPS II scores, these patients needed more resources and had high mortality and prolonged recovery periods after ICU discharge.

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Customised prediction models based on APACHE II and SAPS II scores in patients with prolonged length of stay in the ICU

Abstract: Despite customization, the predictive models may not support clinical decision-making in those patients who require a high share of resources. More relevant instruments are needed for the prediction of outcome of patient groups who consume the major part of ICU resources.

Cited by 49 publications

References 18 publications

Shock on Admission Day Is the Best Predictor of Prolonged Mechanical Ventilation in the ICU

Shock on Admission Day Is the Best Predictor of Prolonged Mechanical Ventilation in the ICU

Untitled

Usefulness of a clinical diagnosis of ICU-acquired paresis to predict outcome in patients with SIRS and acute respiratory failure

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