Predicting Patient Outcome from Intensive Care: A Guide to APACHE, MPM, SAPS, PRISM, and Other Prognostic Scoring Systems

Accurate prognosis is critical to the practice and im provement of intensive care. Recently, a number of gen eral prognostic scoring systems have been developed and their primary goal is to predict patient outcomes. We describe the principles underlying these systems and the methods they use to create predictions. We also explain how predictions of patient outcomes can be used to improve the precision of clinical trials, to evalu ate hospital and intensive care unit use and outcome, and eventually to assist in clinical decision-making.

[1]  W. Knaus,et al.  Acute physiology and chronic health evaluation and Glasgow coma scores. , 1992, Critical care medicine.

[2]  W. Knaus,et al.  Severity Scoring and Prediction of Patient Outcome , 1992 .

[3]  W. Knaus,et al.  APACHE III study design: analytic plan for evaluation of severity and outcome in intensive care unit patients. Implications. , 1989, Critical care medicine.

[4]  A. L. Bishop,et al.  Pharmacodynamics of intravenous ranitidine after bolus and continuous infusion in patients with healed duodenal ulcers , 1989, Clinical pharmacology and therapeutics.

[5]  David Leaper,et al.  APACHE-II SCORE FOR ASSESSMENT AND MONITORING OF ACUTE PANCREATITIS , 1989, The Lancet.

[6]  R. Chang,et al.  INDIVIDUAL OUTCOME PREDICTION MODELS FOR INTENSIVE CARE UNITS , 1989, The Lancet.

[7]  D. McClish,et al.  How Well Can Physicians Estimate Mortality in a Medical Intensive Care Unit? , 1989, Medical decision making : an international journal of the Society for Medical Decision Making.

[8]  A L Brannen,et al.  Prediction of outcome from critical illness. A comparison of clinical judgment with a prediction rule. , 1989, Archives of internal medicine.

[9]  R. Moreau,et al.  Comparison of two simplified severity scores (SAPS and APACHE II) for patients with acute myocardial infarction. , 1989, Critical care medicine.

[10]  W. Knaus,et al.  Interhospital comparisons of patient outcome from intensive care: importance of lead-time bias. , 1989, Critical care medicine.

[11]  W. Knaus,et al.  Multiple systems organ failure: epidemiology and prognosis. , 1989, Critical care clinics.

[12]  R. Dawes,et al.  Heuristics and Biases: Clinical versus Actuarial Judgment , 2002 .

[13]  W. Knaus,et al.  APACHE III study design: analytic plan for evaluation of severity and outcome in intensive care unit patients. Introduction. , 1989, Critical care medicine.

[14]  M. Georgieff,et al.  Validation of two scoring systems which assess the degree of physiologic instability in critically ill newborn infants. , 1989, Critical care medicine.

[15]  D Draper,et al.  Predicting hospital-associated mortality for Medicare patients. A method for patients with stroke, pneumonia, acute myocardial infarction, and congestive heart failure. , 1988, JAMA.

[16]  M. Haupt,et al.  Impact of critical care physician staffing on patients with septic shock in a university hospital medical intensive care unit. , 1988, JAMA.

[17]  S. Lemeshow,et al.  Prospective study of clinical bleeding in intensive care unit patients. , 1988, Critical care medicine.

[18]  D. Nash,et al.  Severity of illness measures: opportunities for clinicians. , 1988, Annals of internal medicine.

[19]  C. Wilcox,et al.  Stress ulcer prophylaxis in medical patients: who, what, and how much? , 1988, The American journal of gastroenterology.

[20]  U. Ruttimann,et al.  Pediatric risk of mortality (PRISM) score. , 1988, Critical care medicine.

[21]  M. Silverstein.  Prediction instruments and clinical judgment in critical care. , 1988, JAMA.

[22]  Richard W. Carlson,et al.  Comparison of clinical assessment with APACHE II for predicting mortality risk in patients admitted to a medical intensive care unit. , 1988, JAMA.

[23]  S. Lemeshow,et al.  Predicting the Outcome of Intensive Care Unit Patients , 1988 .

[24]  S Lemeshow,et al.  Refining intensive care unit outcome prediction by using changing probabilities of mortality. , 1988, Critical care medicine.

[25]  W. Knaus,et al.  Patient selection for intensive care: a comparison of New Zealand and United States hospitals. , 1988, Critical care medicine.

[26]  D. Morris,et al.  Ranitidine--bolus or infusion prophylaxis for stress ulcer. , 1988, Critical care medicine.

[27]  N. Christou,et al.  Treatment of severe intra-abdominal sepsis and/or necrotic foci by an 'open-abdomen' approach. Zipper and zipper-mesh techniques. , 1988, Archives of surgery.

[28]  J. Wood,et al.  A comparison of two ranitidine intravenous infusion regimens in critically ill patients , 1988, Alimentary pharmacology & therapeutics.

[29]  R. Chang,et al.  Predicting outcome among intensive care unit patients using computerised trend analysis of daily Apache II scores corrected for organ system failure , 1988, Intensive Care Medicine.

[30]  D. Peura.  Stress-related mucosal damage: an overview. , 1987, The American journal of medicine.

[31]  G. Zuckerman,et al.  Therapeutic goals and treatment options for prevention of stress ulcer syndrome. , 1987, The American journal of medicine.

[32]  J. Critchlow.  Comparative efficacy of parenteral histamine (H2)-antagonists in acid suppression for the prevention of stress ulceration. , 1987, The American journal of medicine.

[33]  B. Celli,et al.  Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. The role of gastric colonization. , 1987, The New England journal of medicine.

[34]  R. Chang,et al.  Gastrointestinal dysfunction among intensive care unit patients. , 1987, Critical care medicine.

[35]  S. Patton,et al.  Achieving therapeutic goals in insulin-using diabetic patients with non-insulin-dependent diabetes mellitus. A weight reduction-exercise-oral agent approach. , 1987, The American journal of medicine.

[36]  T. Noseworthy,et al.  A randomized clinical trial comparing ranitidine and antacids in critically ill patients , 1987, Critical care medicine.

[37]  W. Knaus,et al.  Identification of low-risk monitor admissions to medical-surgical ICUs. , 1987, Chest.

[38]  J Tinker,et al.  The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. , 1987, The New England journal of medicine.

[39]  L. Jorfeldt,et al.  Cryoprecipitate infusion fails to improve organ function in septic shock. , 1987, Critical care medicine.

[40]  G. Zuckerman,et al.  Prophylactic therapy for stress ulcer bleeding: a reappraisal. , 1987, Annals of internal medicine.

[41]  C. Franklin,et al.  Clinical characteristics and resource utilization of ICU patients: Implications for organization of intensive care , 1987, Critical care medicine.

[42]  H Pastides,et al.  Validation of the mortality prediction model for ICU patients , 1987, Critical care medicine.

[43]  U. Ruttimann,et al.  Accurate prediction of the outcome of pediatric intensive care. A new quantitative method. , 1987, The New England journal of medicine.

[44]  F Halberg,et al.  Circadian rhythm of gastric acid secretion in active duodenal ulcer: chronobiological statistical characteristics and comparison of acid secretory and plasma gastrin patterns with healthy subjects and postvagotomy and pyloroplasty patients. , 1987, Chronobiology international.

[45]  S. Katz.  The science of quality of life. , 1987, Journal of chronic diseases.

[46]  W. Knaus,et al.  An evaluation of outcome from intensive care in major medical centers. , 1987, Canadian critical care nursing journal.

[47]  J. Moore,et al.  Day and night aspirin-induced gastric mucosal damage and protection by ranitidine in man. , 1987, Chronobiology international.

[48]  J. L. Gall,et al.  APACHE II--a severity of disease classification system. , 1986, Critical care medicine.

[49]  Mark H. Johnson,et al.  Stratification of prognosis in granulocytopenic patients with hematologic malignancies using the APACHE‐II severity of illness score , 1986, Critical care medicine.

[50]  W. Knaus,et al.  Physiologic abnormalities and outcome from acute disease. Evidence for a predictable relationship. , 1986 .

[51]  A. Hance,et al.  Intragastric pH profile during acute respiratory failure in patients with chronic obstructive pulmonary disease. Effect of ranitidine and enteral feeding. , 1986, Chest.

[52]  R. Chang,et al.  USE OF APACHE II SEVERITY OF DISEASE CLASSIFICATION TO IDENTIFY INTENSIVE-CARE-UNIT PATIENTS WHO WOULD NOT BENEFIT FROM TOTAL PARENTERAL NUTRITION , 1986, The Lancet.

[53]  O'Rourke Pp.  Outcome of children who are apneic and pulseless in the emergency room. , 1986 .

[54]  C. Bayliff,et al.  The comparative efficacy of cimetidine and ranitidine in controlling gastric pH in critically ill patients , 1986, Canadian Anaesthetists' Society journal.

[55]  M. Girotti,et al.  Factors predicting discharge from intensive care: A Canadian experience , 1986, Canadian Anaesthetists' Society journal.

[56]  W. Knaus.  Rationing, justice, and the American physician. , 1986, JAMA.

[57]  Michael J. Strauss,et al.  Rationing of intensive care unit services. An everyday occurrence. , 1986, JAMA.

[58]  D. Wittmann,et al.  Scheduled reoperations (etappenlavage) for diffuse peritonitis. , 1986, Archives of surgery.

[59]  J. Meakins,et al.  Operative vs percutaneous drainage of intra-abdominal abscesses. Comparison of morbidity and mortality. , 1986, Archives of surgery.

[60]  E. Draper,et al.  Prognosis in Acute Organ‐System Failure , 1985, Annals of surgery.

[61]  H. Sox,et al.  Clinical prediction rules. Applications and methodological standards. , 1985, The New England journal of medicine.

[62]  D. Sherman,et al.  Predicting outcome from hypoxic-ischemic coma. , 1985, JAMA.

[63]  R. Hamman,et al.  Adult respiratory distress syndrome. Prognosis after onset. , 1985, The American review of respiratory disease.

[64]  C J Coulton,et al.  Implications of DRG Payments for Medical Intensive Care , 1985, Medical care.

[65]  L. Johnson,et al.  Cimetidine for prevention and treatment of gastroduodenal mucosal lesions in patients in an intensive care unit. , 1985, Annals of internal medicine.

[66]  H Pastides,et al.  A method for predicting survival and mortality of ICU patients using objectively derived weights , 1985, Critical care medicine.

[67]  D. McClish,et al.  Profile of medical ICU vs. ward patients in an acute care hospital , 1985, Critical care medicine.

[68]  R. Williamson,et al.  Controlled clinical trial of peritoneal lavage for the treatment of severe acute pancreatitis. , 1985, The New England journal of medicine.

[69]  G. Shenfield,et al.  Randomized, prospective trial of cimetidine and ranitidine for control of intragastric pH in the critically ill. , 1985, Surgery.

[70]  J. Meakins,et al.  Surgical infection stratification system for intra-abdominal infection. Multicenter trial. , 1985, Archives of surgery.

[71]  J. L. Gall,et al.  A simplified acute physiology score for ICU patients , 1984, Critical care medicine.

[72]  E. Christensen,et al.  Prognostic Value of Child‐Turcotte Criteria in Medically Treated Cirrhosis , 1984, Hepatology.

[73]  G. Zuckerman,et al.  Prospective evaluation of the risk of upper gastrointestinal bleeding after admission to a medical intensive care unit. , 1984, The American journal of medicine.

[74]  W. Knaus,et al.  The value of measuring severity of disease in clinical research on acutely ill patients. , 1984, Journal of chronic diseases.

[75]  A. Feinstein.  An additional basic science for clinical medicine: I. The constraining fundamental paradigms. , 1983, Annals of internal medicine.

[76]  NIH Consensus Development Conference on Critical Care Medicine , 1983, Critical care medicine.

[77]  W. Knaus,et al.  Identification of Low-Risk Monitor Patients Within a Medical-Surgical Intensive Care Unit , 1983, Medical care.

[78]  John B. Kidd,et al.  Judgement under Uncertainty: Heuristics and Biasses , 1983 .

[79]  D. Cullen,et al.  Therapeutic Intervention Scoring System: Update 1983 , 1983, Critical care medicine.

[80]  S. Horn.  Facilities , 1983, American journal of public health.

[81]  W. Knaus,et al.  A COMPARISON OF INTENSIVE CARE IN THE U.S.A. AND FRANCE , 1982, The Lancet.

[82]  W C Shoemaker,et al.  Clinical trial of survivors' cardiorespiratory patterns as therapeutic goals in critically ill postoperative patients. , 1982, Critical care medicine.

[83]  W. Knaus,et al.  Severity of illness and the relationship between intensive care and survival. , 1982, American journal of public health.

[84]  S. Lemeshow,et al.  Predicting mortality of intensive care unit patients. The importance of coma , 1982, Critical care medicine.

[85]  D. Hosmer,et al.  A review of goodness of fit statistics for use in the development of logistic regression models. , 1982, American journal of epidemiology.

[86]  S. Soldin,et al.  Ranitidine kinetics and dynamics: II. Intravenous dose studies and comparison with cimetidine , 1981, Clinical pharmacology and therapeutics.

[87]  H. Champion,et al.  Trauma score , 1981, Critical care medicine.

[88]  D. E. Lawrence,et al.  APACHE—acute physiology and chronic health evaluation: a physiologically based classification system , 1981, Critical care medicine.

[89]  D. Teres,et al.  Synergistic effect of acute renal failure and respiratory failure in the surgical intensive care unit. , 1981, American journal of surgery.

[90]  R. G. Cornell,et al.  Improvements in burn care, 1965 to 1979. , 1980, JAMA.

[91]  B. Pruitt,et al.  Improvements in burn care. , 1980, JAMA.

[92]  A. Berstad,et al.  Inhibition of gastric secretion in man with a new H2-receptor antagonist, ranitidine. , 1980, Scandinavian journal of gastroenterology.

[93]  C. Metz.  Basic principles of ROC analysis. , 1978, Seminars in nuclear medicine.

[94]  J. C. Ferguson,et al.  A single‐centre double‐blind trial of Trasylol therapy in primary acute pancreatitis , 1978, The British journal of surgery.

[95]  W. Shoemaker,et al.  Prediction of outcome and severity of illness by analysis of the frequency distributions of cardiorespiratory variables , 1977, Critical care medicine.

[96]  G. Diamond,et al.  Medical therapy of acute myocardial infarction by application of hemodynamic subsets (first of two parts). , 1976, The New England journal of medicine.

[97]  R. Bartlett,et al.  Mortality prediction in adult respiratory insufficiency. , 1975, Chest.

[98]  A. Tversky,et al.  Judgment under Uncertainty: Heuristics and Biases , 1974, Science.

[99]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[100]  J. Ranson,et al.  Prognostic signs and the role of operative management in acute pancreatitis. , 1974, Surgery, gynecology & obstetrics.

[101]  J. Civetta,et al.  Therapeutic intervention scoring system: a method for quantitative comparison of patient care. , 1974, Critical care medicine.

[102]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[103]  D. Cullen,et al.  Therapeutic intervention scoring system: a method for quantitative comparison of patient care. , 1974 .

[104]  C. G. Child,et al.  Surgery and portal hypertension. , 1964, Major problems in clinical surgery.