Clinician predictions of intensive care unit mortality
Clinician predictions of intensive care unit mortality
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DOI：
10.1097/01.ccm.0000126402.51524.52
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发表时间：
2004-05-01
影响因子：
8.8
通讯作者：
Guyatt, G
中科院分区：
文献类型：
--
作者：
Rocker, G;Cook, D;Guyatt, G
目的：预测危重病人的预后是重症监护病房与家属讨论的一个重要方面。我们的目的是评估临床强化罕见单位生存预测及其对机械通气专利的影响。设计：前瞻性队列研究。环境：15个三级保健中心。患者：年龄大于或等于18岁的连续机械通气患者，预计重症监护病房住院时间大于或等于72小时。我们记录了重症监护病房入院时的基线特征。我们每天测量多器官功能障碍评分（MODS）、高级生命支持的使用、患者对生命支持的偏好，以及重症监护医师和床边重症监护病房护士估计的重症监护病房生存概率。测量和主要结果。851例患者年龄为61.2（+/-17.6，平均+ SD）岁，急性生理和慢性健康评估（APACHE） 11评分为21.7（+/-8.6）。334例（35.7%）患者死于重症监护病房，341例（40.1%）患者至少接受过一次医生评估
Objective: Predicting outcomes for critically ill patients is an important aspect of discussions with families in the intensive care unit. Our objective was to evaluate clinical intensive rare unit survival predictions and their consequences for mechanically ventilated patents.Design: Prospective cohort study.Setting: Fifteen tertiary care centers.Patients: Consecutive mechanically ventilated patients greater than or equal to18 yrs of age with expected intensive care unit stay greater than or equal to72 hrs.Interventions. We recorded baseline characteristics at intensive care unit admission. Daily we measured multiple organ dysfunction score (MODS), use of advanced life support, patient preferences for life support, and intensivist and bedside intensive care unit nurse estimated probability of intensive care unit survival.Measurements and Main Results. The 851 patients were aged 61.2 (+/-17.6, mean + SD) yrs with an Acute Physiology and Chronic Health Evaluation (APACHE) 11 score of 21.7 (+/-8.6). Three hundred and four patients (35.7%) died in the intensive care unit, and 341 (40.1%) were assessed by a physician at least once to have a