Ethical, legal and organizational issues in the ICU: prediction of outcome

Since the development of the first general outcome prediction models, these instruments have been widely used in the intensive care unit. Last updated in the early 1990s, these models are now severely outdated.

In recent months, researchers and users assisted in several attempts at improving the existing models through customization or expansion or in the development of new models, such as the Simplified Acute Physiology Score (SAPS) 3 and the Acute Physiology and Chronic Health Evaluation (APACHE) IV.

Although not similar, especially in the choice of the reference population, these models aim at replacing older general outcome models, the predictions from which no longer reflect the current case-mix outcomes of intensive care. The objective of this review is to present and discuss, to the clinician working in the intensive care unit, these different strategies and to give an updated version of the general outcome prediction models available in 2006.