模拟ICU患者疾病的严重程度. 系统更新是一个系统更新
1School of Public Health, University of Massachusetts, Amherst 01003.
JAMA
|October 5, 1994
概括
最近对重症监护室 (ICU) 死亡预测系统的修订,如APACHE III,SAPS II和MPM II,显示出对预后和临床试验分层的良好表现. 需要进一步进行直接比较.
科学领域:
- 临界护理医学 临界护理医学
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 估计重症监护室 (ICU) 患者的医院死亡概率对于临床决策和绩效评估至关重要.
- 为了提高准确性,已经开发和修改了几种严重性评分系统.
研究的目的:
- 审查最近对成人ICU患者死亡率预测系统的修订.
- 为了比较这些系统的组件和潜在用途.
主要方法:
- 系统审查已发表的文章,介绍死亡率估计系统.
- 对APACHE III,SAPS II和MPM II的变量,数据库特征和报告的模型性能进行评估.
主要成果:
- APACHE III和SAPS II使用最差的24小时ICU值;MPM II提供多个时间点的模型 (入院,24,48,72小时).
- SAPS II 和 MPM II 模型是完全可实现的; APACHE III 重量是专有的.
- 所有系统表现出良好的性能 (ROC曲线下的面积);SAPS II和MPM II显示出良好的适合性.
结论:
- 所有审查的死亡率预测模型都是基于严格的研究,报告的表现良好.
- 这些系统可以帮助预后评估,ICU性能比较和临床试验患者分层.
- 建议使用常见患者队列进行直接比较,以进一步验证它们的实用性.
相关概念视频
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