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Prognostic models for predicting mortality in elderly ICU patients: a systematic review
Lilian Minne1, Jeroen Ludikhuize, Evert de Jonge
1Department of Medical Informatics, Academic Medical Center, Room J1b-124, PO Box 22660, 1100 DD Amsterdam, The Netherlands. L.Minne@amc.uva.nl
Intensive Care Medicine
|June 8, 2011
Summary
This review found that while mortality prediction models for elderly intensive care unit (ICU) patients had good methodological quality, they lacked clinical credibility and external validation for practical use.
Area of Science:
- Geriatric Medicine
- Intensive Care Medicine
- Health Services Research
Background:
- Prognostic models are crucial for predicting mortality in elderly intensive care unit (ICU) patients.
- Existing models require rigorous validation to ensure clinical applicability.
Purpose of the Study:
- To systematically review the literature on the development and validation of mortality predictive models for elderly ICU patients.
- To assess the fitness of these models for clinical use based on credibility, quality, validity, performance, and effectiveness.
Main Methods:
- A systematic search of the Scopus database was conducted for validation studies of prognostic models in elderly ICU patients.
- Models were evaluated against criteria including clinical credibility, methodological quality, external validity, model performance, and clinical effectiveness.
Main Results:
- Seven studies met inclusion criteria, including one external validation study.
- Seventeen models were identified; eleven were specific to elderly patients.
- Models generally scored well on methodological quality but showed limitations in clinical credibility and external validation.
Conclusions:
- Current mortality prediction models for elderly ICU patients are not sufficiently credible or valid for clinical practice.
- Future research must prioritize external validation, relevant performance measures, and enhanced clinical credibility, incorporating elderly-specific factors.