APACHE scoring and prediction of survival in intensive care

Despite the contribution that APACHE scoring has made in clarifying severity of illness and to the concept of standardised mortality ratios it was not intended to be a method of predicting outcome in individual patients. [...]curtailing costs by limiting admission or continuing treatment according t...

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Bibliographic Details
Published in:BMJ 1995-05, Vol.310 (6988), p.1197-1197
Main Author: Pilkington, S N
Format: Article
Language:English
Subjects:
APACHE
Critical Care
Health Care Rationing
Health outcomes
Humans
Intensive care
Intensive care units
Letter
Letters
Medical prognosis
Mortality
Patients
Prognosis
Treatment Outcome
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Summary:Despite the contribution that APACHE scoring has made in clarifying severity of illness and to the concept of standardised mortality ratios it was not intended to be a method of predicting outcome in individual patients. [...]curtailing costs by limiting admission or continuing treatment according to scoring is invalid. 3 In addition, APACHE scores cannot be used to decide who is to be admitted to an intensive care unit and should not be used to decide on a patient's discharge from an intensive care unit to either a ward or a high dependency area, as frequently patients' scores are similar in each of these areas. 4 Finally, recent evidence suggests that the ability of the APACHE system to predict outcome may be no better than the clinical judgment of physicians and nurses. 5
ISSN:0959-8138
1468-5833
1756-1833
DOI:10.1136/bmj.310.6988.1197b