COMPARISON OF CLINICAL-ASSESSMENT WITH APACHE-II FOR PREDICTING MORTALITY RISK IN PATIENTS ADMITTED TO A MEDICAL INTENSIVE-CARE UNIT
COMPARISON OF CLINICAL-ASSESSMENT WITH APACHE-II FOR PREDICTING MORTALITY RISK IN PATIENTS ADMITTED TO A MEDICAL INTENSIVE-CARE UNIT
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DOI：
10.1001/jama.260.12.1739
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发表时间：
1988-09-23
影响因子：
120.7
通讯作者：
CARLSON, RW
中科院分区：
文献类型：
--
作者：
KRUSE, JA;THILLBAHAROZIAN, MC;CARLSON, RW
APACHE II（急性生理和慢性健康评估）系统已被广泛用作预测重症II期患者预后的客观手段。我们对连续入住重症监护病房的患者进行前瞻性评估，比较APACHE II的预测准确性与重症监护人员的临床评估。在入住重症监护室时，要求负责每位患者的院舍工作人员和护士估计患者在医院的死亡风险。计算患者的APACHE II评分，然后根据该评分计算患者住院死亡风险的预测。共研究了366例患者。死亡率预测来自57名医生和33名重症护理护士。我们无法证明APACHE II预测的准确性与医生或护士的预测有显著差异。临床评估和APACHE II均可高度预测预后。
The APACHE II (Acute Physiology and Chronic Health Evaluation) system has been widely used as an objective means of predicting outcome in critically II patients. we prospectively evaluated patients consecutively admitted to the medical intensive care unit to compare the predictive accuracy of APACHE II with clinical assessment by critical care personnel. At the time of admission to the intensive care unit, the house staff and nurse responsible for each patient were asked to estimate the patient''s hospital mortality risk. The patient''s APACHE II score was calculated and a prediction of the patient''s hospital mortality risk was then computed on the basis of this score. A total of 366 patients were studied. Mortality predictions were obtained from 57 physicians and 33 critical care nurses. We were unable to demonstrate a significant difference in the accuracy of APACHE II predictions compared with either physicians'' or nurses'' predictions. Clinical assessment and APACHE II were both highly predictive of outcome.