Outcome prediction models on admission in a medical intensive care unit

Jh, Schäfer; Maurer, Adrian J.; Jochimsen, Friederike; Emde, C; Wegscheider, Karl; Hr, Arntz; Heitz, James W.; Krell-Schroeder, B; Distler, A.

doi:10.1097/00003246-199010000-00012

Cited by 56 publications

(14 citation statements)

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“…Studies comparing other methodologies have shown significant variation across hospitals (Knaus et al 1993; Sirio et al 1999; Render et al 2005). Questions remain how much of this variation is from true differences in outcome and how much is dependant on the scoring system utilized (Puri, 2005; Capuzzo et al 2000; McNelis et al 2001; Beck et al 2003; Schafer et al 1990; Iezzoni et al 1995). …”

Section: Discussionmentioning

confidence: 99%

Use of the All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality Score as a Severity Adjustor in the Medical ICU

Baram

Daroowalla

Garcia

et al. 2008

Clinical medicine. Circulatory, respiratory and pulmonary medic

106

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Section: Discussionmentioning

confidence: 99%

Use of the All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality Score as a Severity Adjustor in the Medical ICU

Baram

Daroowalla

Garcia

et al. 2008

Clinical medicine. Circulatory, respiratory and pulmonary medic

106

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show abstract

“…Ancak bunun nedeninin tedavi şeklinden mi, yoksa olgu seçimi ölçüt-lerinden mi kaynaklandığı bilinmemektedir. [7,8] Schäfer ve ark., [9] APACHE II, SAPS ve MPM ile öngörülen mortalite riskini, gözlenen mortalite oranı ile karşılaştırmış-lar; öngörülen mortalite riskini yeterli bulmamışlardır. Bir modelin uygulanabilirliği; ancak söz konusu popü-lasyonda test edilmesi ve geçerliliğinin anlaşılmasından sonra olabilir.…”

Section: Discussionunclassified

Comparison Of The Efficacy Of Saps Ii And Mpm Ii Scoring Systems In Intensive Care Unit Mortality

Eroğlu¹,

Aslan²,

Yavuz³

et al. 2008

TUTFD

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Objectives:We aimed to investigate the predicting performances of Simplified Acute Physiology Score (SAPS) II and Mortality Probability Model (MPM) II 0 and MPM II 24 on determining the mortality rates of intensive care unit (ICU) patients. Patients and Methods:Consecutive 100 patients admitted to the ICU were investigated retrospectively, and 92 of them were included in the study. Initial SAPS and MPM analysis and calculations for mortality prediction percentages were performed with auxiliary software package. Transfer data, total ICU and hospital stay and duration of mechanical ventilation were calculated. Results:Most of the patients (53%) were transferred to the ICU from the emergency department. Twenty two patients were transferred to another department and 15 patients were discharged. The number of patients died were 50, the mortality rate was determined as 54%. The ICU stay and duration of mechanical ventilation of patients who died were found as statistically significant (p=0.007, p=<0.0001, respectively). Conclusion:Although SAPS II, MPM II 0 and MPM II 24 analysis are related to mortality, they have no effect on predicting the mortality independent from logistic regression analysis. The predicted mortality rates were found related with those determined by logistic regression analysis. Duration of mechanical ventilation and ICU stay and mechanical ventilation duration above 24 hours affect the predicted mortality, independently. Hastalar ve Yöntemler:Üniversite hastanemiz YBÜ'süne kabul edilen ardışık 100 hastanın verileri geriye dönük olarak incelendi, 92 hasta çalışmaya alındı. Hastaların SAPS II ve MPM başlangıç verilerinin değerlendirilmesi ve mortalite öngörü oranlarının hesaplanması yardımcı yazılım ile yapıldı. Hastaların YBÜ'ye geldiği yer, YBÜ ve hastanede kalış süresi ve mekanik ventilasyon süreleri hesaplandı. Bulgular:Yoğun bakım ünitesine en çok hasta, hastanemiz acil servisinden (%53) kabul edilmişti. Yirmi yedi hasta başka bir servise devir, 15 hasta ise taburcu edildi. Ölen hastaların sayısı 50, mortalite oranı ise %54 olarak saptandı. Yoğun bakım ünitesinde kalış ve mekanik ventilasyon süreleri ölen hastalarda istatistiksel olarak anlamlı bulundu (sırasıyla p=0.007, p=<0.0001).Sonuç: SAPS II, MPM II 0 ve MPM II 24 analizlerinin tümü-nün mortalite ile ilişkisi olmakla beraber lojistik regresyon analizinden bağımsız olarak mortaliteyi öngörmede etkileri yoktur. Öngörülmüş ölüm oranları lojistik regresyon analizi ile gözlenen ölüm oranlarıyla ilişkili bulunmuştur. Mekanik ventilasyon ve YBÜ'de kalış süreleri ile 24 saatten uzun süren mekanik ventilasyon süresi öngörülen mortaliteyi bağımsız olarak etkilemektedir.Anahtar sözcükler: SAPS II; MPM II 0 ; MPM II 24 ; yoğun bakım ünitesi mortalitesi.

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“…The SMR is, thus, a death rate that is case mix-adjusted by comparison with the original inception group. 88,183,184 Although unable to predict individual outcomes with sufficient accuracy to evaluate care for individual patients, 190,191 the SMR performs reasonably well for patient cohorts. 183,185,[192][193][194][195] Other than short-term mortality, the list of performance measures for which validated prediction equations allow case-mix adjustments is brief.…”

Section: Measuring and Interpreting Icu Performancementioning

confidence: 99%

“…Even for the few performance parameters included in these systems, there are problems related to calibration, 178,179,190,196 accuracy within some diagnostic subsets, 190,197 generalizability to other countries, 198,199 and aging of the inception data set. 184,200 In addition, none of these systems adjust for nonphysiologic parameters, which may be important determinants of outcomes, such as socioeconomic factors.…”

Section: Measuring and Interpreting Icu Performancementioning

confidence: 99%