ICU scoring systems do not allow prediction of patient outcomes or comparison of ICU performance

Recent revisions of the major ICU scoring systems have broadened their database markedly and increased their statistical accuracy. For a specific patient, however, the systems cannot be accurate enough to direct management decisions. Significant questions remain about the reliability of these systems for comparing different ICUs and different patient populations, especially in surgical and trauma patients. Current scoring systems, therefore, cannot be used reliably in either the management of the individual patient or in the making of quality comparisons between ICUs.