Predicting survival, length of stay, and cost in the surgical intensive care unit : APACHE II versus ICISS. Discussion.
Annual meeting of the Eastern Association for the Surgery of Trauma. Sanibel, FL, USA, 1998/01/14.
Risk stratification of patients in the intensive care unit (ICU) is an important tool because it permits comparison of patient populations for research and quality control.
Unfortunately, currently available scoring systems were developed primarily in medical ICUs and have only mediocre performance in surgical ICUs.
Moreover, they are very expensive to purchase and use.
We conceived a simple risk-stratification tool for the surgical ICU that uses readily available International Classification of Diseases, Ninth Revision, codes to predict outcome.
Called ICISS (International Classification of Disease Illness Severity Score), our score is the product of the survival risk ratios (obtained from an independent data set) for all International Classification of Diseases, Ninth Revision, diagnosis codes.
A total of 5,322 noncardiac patients admitted to a surgical ICU during an 8-year period had their Acute Physiology and Chronic Health Evaluation (APACHE) II scores compared with their ICISS as predictors of outcome (survival/non-survival, length of stay, and charges).
ICISS proved to be a much better predictor of survival than APACHE (receiver operating characteristic (ROC) APACHE=0.806 ; Hosmer-Lemeshow (HL) APACHE=22.56 ; ROC ICISS=0.892 ; HL ICISS=12.06) or the APACHE survival probability (ROC=0.836 ; HL=34.47).
These differences were highly statistically significant (p<0.001). (...)
Mots-clés Pascal : Réanimation, Chirurgie, Unité soin intensif, Epidémiologie, Evaluation, Echelle mesure, Pronostic, Valeur prédictive, Traitement, Indice gravité, Méthodologie, Etude comparative, Précision, Homme
Mots-clés Pascal anglais : Resuscitation, Surgery, Intensive care unit, Epidemiology, Evaluation, Measurement scale, Prognosis, Predictive value, Treatment, Severity score, Methodology, Comparative study, Accuracy, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0419667
Code Inist : 002B27B14C. Création : 25/01/1999.