Scoring systems in the intensive care unit: A compendium

Abstract

Severity scales are important adjuncts of treatment in the intensive care unit (ICU) in order to predict patient outcome, comparing quality-of-care and stratification for clinical trials. Even though disease severity scores are not the key elements of treatment, they are however, an essential part of improvement in clinical decisions and in identifying patients with unexpected outcomes. Prediction models do face many challenges, but, proper application of these models helps in decision making at the right time and in decreasing hospital cost. In fact, they have become a necessary tool to describe ICU populations and to explain differences in mortality. However, it is also important to note that the choice of the severity score scale, index, or model should accurately match the event, setting or application; as mis-application, of such systems can lead to wastage of time, increased cost, unwarranted extrapolations and poor science. This article provides a brief overview of ICU severity scales (along with their predicted death/survival rate calculations) developed over the last 3 decades including several of them which has been revised accordingly.

Clinical factors associated with weaning failure in patients requiring prolonged mechanical ventilation

“…Therefore, further studies are required to determine whether COPD reduces weaning success in patients requiring PMV. The SOFA scoring system, which was introduced in 1994, is a reliable predictive factor of mortality during ICU stay (28). Gnanapandithan et al reported that the value of the baseline SOFA scores at baseline was related to successful extubation from MV (29).…”

Assessment of Renal Damage in Patients with Multi-Drug Resistant Strains of Pneumonia Treated with Colistin

“…These prognoses may be useful in estimating patient's physiologic in- (46) stability upon admission (46). In addition, severity scoring and forecasting mortality for each patient can be performed along with clinical assessment in the ICU in order to increase chances of survival (47,48). Based on the findings of the current study, there was a positive significant association between APACHE-II score, renal damage, mortality, and ICU duration.…”

The Analysis of Scoring Systems Predicting Mortality in Geriatric Emergency Abdominal Surgery

“…Hospital mortality is predicted using the APACHE II score, the principal diagnostic category with which the patient is admitted to ICU and also depending on whether or not the patient required emergency surgery. [12] In a recent study, APACHE II has also had a better, more appropriate calibration than other widely used scoring systems; so only APACHE II properly predicts mortality risk. [11] The major limitation of this scoring system is the varibility of physiological parameters which are all dynamic and can be influenced by multiple factors, including ongoing resuscitation and treatment, hence, time bias is present.…”