Predicting outcome in intensive therapy units―a comparison of Apache II with subjective assessments

In a prospective study 568 patients admitted to a mixed medical and surgical intensive therapy unit (ITU) were assessed using the Apache II severity of illness score to predict outcome. Their outcome was also predicted subjectively by a doctor and nurse on admission. There were 260 deaths in the gro...

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Bibliographic Details
Published in:Intensive care medicine 1991-01, Vol.17 (3), p.159-163
Main Authors: MARKS, R. J, SIMONS, R. S, BLIZZARD, R. A, BROWNE, D. R. G
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Decision Making
Emergency and intensive care: techniques, logistics
Humans
Intensive care medicine
Intensive care unit. Emergency transport systems. Emergency, hospital ward
Intensive Care Units
Medical sciences
Medical Staff, Hospital - psychology
Mortality
Nursing Assessment - standards
Predictive Value of Tests
Prognosis
Prospective Studies
Sensitivity and Specificity
Severity of Illness Index
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Summary:In a prospective study 568 patients admitted to a mixed medical and surgical intensive therapy unit (ITU) were assessed using the Apache II severity of illness score to predict outcome. Their outcome was also predicted subjectively by a doctor and nurse on admission. There were 260 deaths in the group. The subjective predictions were compared with the Apache II predictions using logistic regression analysis and receiver-operating-characteristic curve measurement. The subjective assessments were found to be a more powerful predictor of outcome in this group of patients than the Apache II scores and predicted risk of death. Although the predictions could be successfully applied to the population as a whole, none of the tests were suitable for predicting outcome on an individual patient.
ISSN:0342-4642
1432-1238
DOI:10.1007/BF01704720