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[Prognostic systems in intensive care: TRISS, SAPS II, APACHE III]
S Barbieri1, E Michieletto, P Feltracco
1Dipartimento di Farmacologia ed Anestesiologia, Egidio Meneghetti, Sede di Anestesiologia e Rianimazione, Università degli Studi, Padova, Italy.
Minerva Anestesiologica
|October 17, 2001
Summary
The APACHE III and TRISS scoring systems accurately predict mortality in polytrauma patients admitted to the ICU. These trauma scoring systems are valuable tools for evaluating patient outcomes and treatment effectiveness.
Area of Science:
- Critical Care Medicine
- Trauma Surgery
- Prognostic Modeling
Background:
- Polytrauma patient outcomes are influenced by physiological dysfunction, injury severity, age, and injury mechanism.
- Accurate prediction of mortality is crucial for managing intensive care unit (ICU) patients.
Purpose of the Study:
- To validate the accuracy of the APACHE III, SAPS II, and TRISS scoring systems for predicting mortality in polytrauma patients upon ICU admission.
- To compare the predictive performance of different trauma scoring systems.
Main Methods:
- A cohort of 93 polytraumatized patients admitted to the ICU between October 1998 and October 1999 was analyzed.
- Patients were assessed using APACHE III, SAPS II, Revised Trauma Score, and Injury Severity Score.
- Predictive accuracy was evaluated using decision matrix analysis, comparing observed versus predicted outcomes.
Main Results:
- All trauma scoring systems demonstrated high accuracy rates in predicting mortality.
- The accuracy was particularly notable when using a 40% positive test criterion.
Conclusions:
- Prognostic scales, especially TRISS and APACHE III, showed good correlation between expected and observed mortality.
- The APACHE III system emerged as the most reliable predictor among those analyzed.
- Despite underutilization, these scales are valuable for treatment evaluation in polytraumatized patients.