- Meeting abstract
- Open Access
Severity of illness, critical events, organ failure assessment and ICU outcome
© Current Science Ltd 2000
- Published: 21 March 2000
- Predictive Power
- Organ Failure
- Final Outcome
- Intermediate Outcome
- Critical Event
The use of general outcome prediction models in the ICU remains controversial: 1) none of the existing systems is able to precisely predict individual outcome; 2) based on data collected within the first 24 h after admission, their prediction power is insensitive to alternative courses of care (and of ways-of-working) in the ICU.
To evaluate the importance of intermediate outcomes of care upon the final outcome of patient care in the ICU; to evaluate whether the consideration of intermediate outcomes of care do increase the predictive power of SAPS II score.
Prospective, multi-center and multinational study.
47 ICU's from 9 European countries.
All consecutive admissions were enrolled during a four-month period.
admission data; first day SAPS II score; hourly registration of Critical Events (CrEv) defined as the duration (in hours) of out-of-range measurements of four parameters (heart rate, blood pressure, urine output and oxygen saturation); Sequential Organ Failure Score (SOFA) at admission and then every 24 h; ICU outcome.
Final outcome: ICU mortality. Intermediate outcomes: SOFA and CrEv, expressed as the percentage of time spent in CrEv (single or combined). SOFA computations included total daily score and Delta-SOFA .
variables included for explaining final outcome (the dependent variable) on Day 3 through Day 10: Day 1 SAPS II score; intermediate outcome variables (SOFA and CrEv) on Day 1, Day 3 and Day 5.
Data on 1633 patients were analysed: median age of 69 years; median SAPS II score of 35 and ICU mortality rate of 14%. Including the variables indicated in a logistic regression, three models (Table) could be constructed.
Mean ± sd
SOFA day 1
CrEv day 1
SOFA day 3
CrEv day 3
SOFA day 5
CrEv day 5