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Related Experiment Video

Updated: Sep 13, 2025

An R-Based Landscape Validation of a Competing Risk Model

An R-Based Landscape Validation of a Competing Risk Model

Published on: September 16, 2022

New prognostic score for mortality in critically ill patients. Development and validation.

M P Gracia Arnillas¹, F Alvarez Lerma¹, X Nuvials Casals²

¹Critical Care Department, Hospital Universitari del Mar, Passeig Marítim 25-29, 08003 Barcelona, Spain.

Journal of Critical Care

|August 2, 2025

Summary

A new prognostic model accurately predicts intensive care unit (ICU) mortality by incorporating nine additional risk factors beyond APACHE II. This novel model enhances risk stratification for critically ill patients, improving patient outcomes.

Keywords:

Critical ill patient Mortality Prognostic score

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Establishing a Competing Risk Regression Nomogram Model for Survival Data

Establishing a Competing Risk Regression Nomogram Model for Survival Data

Published on: October 23, 2020

Area of Science:

Critical Care Medicine
Prognostic Modeling
Health Informatics

Background:

Predicting mortality in critically ill patients is crucial for effective resource allocation and treatment strategies.
Existing models like APACHE II have limitations in capturing dynamic risk factors throughout the ICU stay.

Purpose of the Study:

To develop and validate a novel prognostic model (NMP) for predicting ICU mortality.
To improve upon the predictive accuracy of the APACHE II score by incorporating dynamic risk factors.

Main Methods:

A post-hoc analysis of multicenter, prospective data from 167 Spanish hospitals (193 ICUs) over 7 years.
Multivariable logistic regression was used to develop the model in an estimation group and validated in a separate cohort.
The NMP incorporated APACHE II and nine additional factors assessed throughout the ICU stay.

Main Results:

The study analyzed 137,666 patients, with 91,777 in the estimation group and 45,889 in validation.
The NMP demonstrated superior discriminatory ability (AUROC = 0.872) compared to APACHE II alone (AUROC = 0.826).
The NMP improved reclassification by 52%, identifying survivors and non-survivors more accurately.

Conclusions:

A validated novel prognostic model (NMP) was developed, incorporating nine additional risk factors alongside APACHE II.
The NMP offers enhanced risk stratification for critically ill patients, aiding clinical decision-making.
This model provides a more comprehensive evaluation of mortality risk throughout the ICU stay.