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ICU Scores:

Scoring systems represent classification systems or point systems which have been designed for making quantitative statements regarding the severity of a disease, its prognosis, and its course. Furthermore, scores may serve the purposes of assessing therapies, of quality control and of quality assurance, and of an economic evaluation of intensive care. Like all measuring methods, scores are susceptible to failures and systematic mistakes. The clinical user should be well aware of these limitations. Generally, one would recommend only using scores which have been rigorously tested for their reliability, validity, and practicability. These include, but are not limited to, the updated versions of the APACHE, the SAPS, and the MPM. Although great strides have been made concerning development, verification, and clinical applicability, scores still exhibit a level of uncertainty which precludes their use in individual patients. Frequently, it may be of benefit to combine the more general scores with one or several organ dysfunction scores to determine the extent of functional impairment of specific organs. If, however, well-trained medical personnel apply tried and tested scoring systems, intensive care units will definitely gain a lot from it.

The following pages provide an access to different critical care scoring systems used to classify patients according to severity of illness. It is meant to be an easy "on line" calculation of these scores used in general or specialized Intensive Care Units. The only purpose is the actual calculation of the scores, irrespective of any judgement on their relevance, usefulness or intrepretation of the results.

Critical Care Scoring Systems
APACHE IV:
Acute Physiology and Chronic Health Evaluation System
APACHE II:
Acute Physiology and Chronic Health Evaluation System
SAPS II
Simplified Acute Physiology Score
MPM 0
Mortality Prediction Model at admission
MPM 24
Mortality Prediction Model after 24 hours
MPM 48
Mortality Prediction Model after 48 hours
MPM Over Time
Mortality Prediction Model Over Time
SOFA
Sequential Organ Failure Assessment
MODS
Multiple Organ Dysfunction Score
PRISM
Pediatric Risk of Mortality

References:

Modeling the severity of illness of ICU patients. A systems update.
JAMA. 1994 Oct 5;272(13):1049-55.

Recent innovations in intensive care unit risk-prediction models.
Curr Opin Crit Care. 2002 Aug;8(4):321-30. Review.

Assessment of six mortality prediction models in patients admitted with severe sepsis and septic shock to the intensive care unit: a prospective cohort study.
Crit Care. 2003 Oct;7(5):R116-22. Epub 2003 Aug 28.

Intensive Care Society's Acute Physiology and Chronic Health Evaluation (APACHE II) study in Britain and Ireland: a prospective, multicenter, cohort study comparing two methods for predicting outcome for adult intensive care patients.
Crit Care Med. 1994 Sep;22(9):1392-401.

Scoring systems in the intensive care unit
Anaesthesist. 2003 Oct;52(10):965-87; quiz 988-9. Review. German.

Rating the quality of intensive care units: is it a function of the intensive care unit scoring system?
Crit Care Med. 2002 Sep;30(9):1976-82.

Severity scores in respiratory intensive care: APACHE II predicted mortality better than SAPS II.
Respir Care. 1995 Oct;40(10):1042-7. Review.

Predicting outcome in critical care: the current status of the APACHE prognostic scoring system.
Can J Anaesth. 1991 Apr;38(3):374-83. Review

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