TY - CHAP M1 - Book, Section TI - Assessment of Severity of Illness A1 - Russell, James A. A2 - Hall, Jesse B. A2 - Schmidt, Gregory A. A2 - Kress, John P. PY - 2015 T2 - Principles of Critical Care, 4e AB - In the last four decades, intensive care units (ICUs) and critical care researchers have amassed a great body of pathophysiologic and clinical knowledge that has advanced the care of critically ill patients. Severity of illness scoring systems are tools that have been designed to both predict and evaluate, from multiple perspectives, the outcomes of critically ill patients.Most scoring systems evolved from multivariate regression analysis applied to large clinical databases of discovery cohorts to identify the most relevant factors for prediction of mortality. Scoring systems are then validated by prospective application to independent validation cohorts.The ideal components of a scoring system are data collected during the course of routine patient management that are easily measured in most or all patients, inexpensive, objective, and reproducible.The most widely applied scoring systems in adults are the Acute Physiology and Chronic Health Evaluation (APACHE), the Mortality Probability Models (MPM), Simplified Acute Physiology Score (SAPS), and Sequential Organ Failure Assessment (SOFA).The uses of severity-of-illness scoring systems for cohorts of patients include clinical investigation (to compare study groups usually at baseline but sometimes over the course of ICU care), ICU administration (to guide resource allocation and budget), and assessment of ICU performance (to compare performance over time or between health care settings).The use of scores to guide decisions about delivery of care to individual patients is controversial; in some studies the accuracy of prediction of outcomes of scoring systems is not greater than that of the individual clinician's judgment. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1107715292 ER -