Elsevier

Clinics in Chest Medicine

Volume 24, Issue 4, December 2003, Pages 751-762
Clinics in Chest Medicine

Prognostication and intensive care unit outcome: the evolving role of scoring systems

https://doi.org/10.1016/S0272-5231(03)00094-7Get rights and content

Section snippets

General overview of importance and limitations of scoring systems

Scoring systems were initially developed to provide some quantification of case mix and estimates of outcome probabilities, where outcome was usually measured as death. The following is a brief and generic discussion of the relative merits and limitations of scoring systems as originally outlined by Rowan [10].

Scoring systems: prognostic scores versus organ dysfunction (outcome) measures

The goals for each of these scoring systems are different but may be seen as complementary. The prognostic scales were designed to be used early during the ICU stay, typically in the first 24 hours following admission. They are based on physiologic measures that were selected to maximize prediction of mortality. Organ dysfunction measures capture the clinical course over time and can be determined at any point during the ICU stay. They are based on measures of physiology and therapeutic

Summary

Prognostic scoring systems remain important in clinical practice. They enable us to characterize our patient populations with robust measures for predicted mortality. This allows us to audit our own experience in the context of institutional quality control measures and facilitates, albeit imperfectly, comparisons across units and patient populations. Practically, they provide an objective means to characterize case-mix and this helps to quantify resource needs when negotiating with hospital

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