Short-term mortality predictions for critically ill hospitalized adults: science and ethics.
Short-term mortality predictions for critically ill hospitalized adults: science and ethics.
复制标题
危重住院成人的短期死亡率预测：科学与伦理。
DOI：
10.1126/science.1925596
复制
发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Lynn,J
中科院分区：
文献类型：
--
作者：
Knaus,WA;Wagner,DP;Lynn,J
现代生命维持疗法通常能成功地推迟死亡，但在恢复健康方面可能无效。影响个人死亡时间和情况的决定现在很常见，需要对可能的结果进行准确和全面的描述。对替代结局的评价需要承认，大多数患者发现某些结局比死亡更糟糕。对患者结局主要预测因素的理解不断加深，加之收集和处理大量详细临床数据的技术能力迅速发展，为估计重症医学护理的结局创造了新的知识和技术基础。这种客观的概率估计，如本文所述的系统，可以减少困难的临床决策的不确定性，并可用于医生，患者和社会重新定位医疗保健向更科学和道德的辩护方法。
Modern life-sustaining therapy often succeeds in postponing death but may be ineffective at restoring health. Decisions that influence the time and circumstances of an individual's death are now common and require an accurate and comprehensive characterization of likely outcome. Evaluation of alternative outcomes requires acknowledgment that most patients find some outcomes to be worse than death. Improved understanding of major predictors of patient outcome, combined with rapidly expanding technical abilities to collect and manipulate large amounts of detailed clinical data, have created a new intellectual and technical basis for estimating outcomes from intensive medical care. Such objective probability estimates, such as the system described here, can reduce uncertainty about difficult clinical decisions and can be used by physicians, patients, and society to reorient health care toward more scientifically and ethically defensible approaches.