Elsevier

Critical Care Clinics

Volume 23, Issue 3, July 2007, Pages 639-658
Critical Care Clinics

Severity of Illness and Organ Failure Assessment in Adult Intensive Care Units

https://doi.org/10.1016/j.ccc.2007.05.004Get rights and content

The critical care community has been using severity and organ failure assessment tools for over 2 decades. The major adult severity assessment models are Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score, and Mortality Probability Model. All three recent versions of these models perform well in predicting hospital mortality. Sequential Organ Failure Assessment score is the most used tool for assessment of multiple organ failure. These tools have been used extensively in clinical research involving critically ill patients and for benchmarking and the measurement of performance improvement. Their roles as clinical decision support tools at the bedside await future studies because of their unknown or poor performance at the individual patient level.

Section snippets

Model creation

Development of a prognostic model requires the identification of reliable predictive variables, precise definition of predictor and outcome variables, collection of data on the predictive and outcome variables, analysis of the relationship between the predictor and outcome variables, and validation of this relationship in a new independent database [12]. Predictor variables entered in a model should be routinely available, reliable, and independent of ICU intervention to eliminate treatment

Introduction/creation

Multiple organ failure is a major cause of morbidity and mortality in the ICU. The main treatment plans of critically ill patients depend on supporting failing organs. Initial and sequential assessments of the failing organs provide information about the patients' prognoses as well as the effectiveness of treatment. Several models have been developed to assess the degree of organ dysfunction [10]. Most organ failure assessment systems assign values to six organ systems: respiratory,

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    B.A. was supported by Mayo Clinic Critical Care Research fund and Department of Medicine, Quality QUEST.

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