Prospective evaluation of residents and nurses as severity score data collectors

Holt, Andrew; Bury, L K; Bersten, Andrew D.; Skowronski, George; Vedig, A. E.

doi:10.1097/00003246-199212000-00015

Cited by 56 publications

(36 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been shown that the main causes of data errors in computing APS of APA-CHE II are the choice between highest or lowest value as worst and the Glasgow Coma Score evaluation [20]. Nevertheless, variations in individual prediction are not reflected in collective predictions, as reported by Chen et al for APACHE II [21].…”

Section: Discussionmentioning

confidence: 97%

Validation of severity scoring systems SAPS II and APACHE II in a single-center population

et al. 2000

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

Validation of severity scoring systems SAPS II and APACHE II in a single-center population

et al. 2000

View full text Add to dashboard Cite

show abstract

“…In other words, it can be said that the prognostic importance of the degree of liver failure appears to be higher in GICUs than in general ICUs. In addition to predictive accuracy, for any predictive model to be clinically useful it must also show reproducibility and be easy to use at the bedside (49,50). The APACHE II and SAPS II scores are calculated with objective variables included in the standard monitoring of critically ill patients, but their use in daily routines has been impeded by the need to process data by computer (17,18,20,21,40,44).…”

Section: Discussionmentioning

confidence: 99%

Prognostic scores in cirrhotic patients admitted to a gastroenterology intensive care unit

Freire

Romãozinho²,

Amaro³

et al. 2011

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Aim: to assess the prognostic accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment (SOFA), Model for End-stage Liver Disease (MELD) and ChildPugh-Turcotte (CPT) in predicting GICU mortality in cirrhotic patients.Methods: the study involved 124 consecutive cirrhotic admissions to a GICU. Clinical data, prognostic scores and mortality were recorded. Discrimination was evaluated with area under receiver operating characteristic curves (AUC). Calibration was assessed with Hosmer-Lemeshow goodness-of-fit test.Results: GICU mortality was 9.7%. Mean APACHE II, SAPS II, SOFA, MELD and CPT scores for survivors (13.6, 25.4, 3.5, 18.0 and 8.6, respectively) were found to be significantly lower than those of non-survivors (22.0, 47.5, 10.1, 30.7 and 12.5, respectively) (p < 0.001). All the prognostic systems showed good discrimination, with AUC = 0.860, 0.911, 0.868, 0.897 and 0.914 for APACHE II, SAPS II, SOFA, MELD and CPT, respectively. Similarly, APACHE II, SAPS II, SOFA, MELD and CPT scores achieved good calibration, with p = 0.146, 0.120, 0.686, 0.267 and 0.120, respectively. The overall correctness of prediction was 81.9%, 86.1%, 93.3%, 90.7% and 87.7% for the APA-CHE II, SAPS II, SOFA, MELD and CPT scores, respectively.Conclusions: in cirrhotics admitted to a GICU, all the tested scores have good prognostic accuracy, with SOFA and MELD showing the greatest overall correctness of prediction. INTRODUCTIONPrognostic models are used for comparison and quality assessment of different Intensive Care Units (ICUs) and within the same ICU over time, for audit and clinical research, for evaluating therapeutic effectiveness and for guiding discussions between clinicians and families (1-6).The incidence of liver cirrhosis is increasing exponentially and cirrhotic patients admitted to ICUs have high mortality rates and a high rate of consumption of resources (7-18). Furthermore, a significant percentage (36.7%) of the total cost of ICU care for cirrhotic patients is spent on those who do not survive (11,16,19). Additionally, it must be borne in mind that ICUs are a very limited health resource (10,11,18). Thus, predictive models could be very important decision-making tools in this setting.Two types of prognostic scores can be used in cirrhotics admitted to ICUs: general prognostic models and disease-specific models. The general prognostic models include two main categories: firstly, those evaluating severity of illness, namely the Acute Physiology and Chronic Health Evaluation (APACHE) II (20) and Simplified Acute Physiology Score (SAPS) II (21); secondly, models quantifying organ dysfunction and failure, of which the most widely-used is the Sequential Organ Failure Assessment (SOFA) (22,23 Vol. 103. N.° 4, pp. 177-183, 2011 Received: 04-10-10. Accepted: 02-12-10.

show abstract

“…26 For any predictive model to be clinically useful, it must show ease of use, accuracy, acceptance by the data collecting staff, and reproducibility. 29 The SOFA system has already been used sucessfully in large numbers of critically ill patients. 15,16,30,31 The variables needed to record the SOFA are derived from standard monitoring of critically ill patients and calculation at the bedside takes 3 minutes.…”

Section: Discussionmentioning

confidence: 99%

Short-term prognosis in critically ill patients with cirrhosis assessed by prognostic scoring systems

et al. 2001

View full text Add to dashboard Cite

The short-term prognosis of acutely ill patients with cirrhosis is influenced by the degree of hepatic insufficiency and by dysfunction of extrahepatic organ systems. The purpose of this study was to assess and compare the prognostic accuracy of the Child-Pugh classification, the Acute Physiology and Chronic Health Evaluation (APACHE) II system and the Sequential Organ Failure Assessment (SOFA) for predicting hospital mortality in patients with cirrhosis when used 24 hours after admission to a medical intensive care unit (ICU). Prospective data were recorded on 143 patients. Cumulative mortality rates were 36% in the ICU, 46% in the hospital, and 56% at 6-month follow-up. By using the area under receiver operating characteristic (AUROC) curves, the SOFA showed an excellent discriminative power (AU-ROC 0.94), which was clearly superior to the APACHE II (AUROC 0.79) and the Child-Pugh system (AUROC 0.74). Hospital mortality rates below and above a cutoff of 8 SOFA points were 4% and 88%, respectively (P < .0005). The SOFA score also reflected resource use during the ICU treatment as measured by daily workload and length of stay. The SOFA is an easily applied tool with excellent prognostic abilities and can be used to enhance clinical judgment of prognosis as well as providing patients and families with objective information. (HEPATOLOGY 2001;34:255-261.)

show abstract

Prospective evaluation of residents and nurses as severity score data collectors

Cited by 56 publications

References 0 publications

Validation of severity scoring systems SAPS II and APACHE II in a single-center population

Validation of severity scoring systems SAPS II and APACHE II in a single-center population

Prognostic scores in cirrhotic patients admitted to a gastroenterology intensive care unit

Short-term prognosis in critically ill patients with cirrhosis assessed by prognostic scoring systems

Contact Info

Product

Resources

About