METHODOLOGIC STUDIES ON APACHE III

APACHE III 方法学研究

• 批准号: 3371604
• 负责人: WILLIAM A KNAUS
• 金额: $ 37.7万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-01-01 至 1992-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3371604
• 关键词: acute disease /disorder; chronic disease /disorder; decision making; diagnosis service; diagnostic catheterization; disease /disorder classification; health care cost /financing; health care facility information system; health care quality; health care service evaluation; hospital utilization; human therapy evaluation; intensive care; pathology; patient care management; prognosis; pulmonary artery

There is a continued and growing need for better tools to evaluate the efficacy and effectiveness of modern medical care. This project will extend the development and application of the APACHE (Acute Physiology and Chronic Health Evaluation) severity of illness classification system to the analysis and study of modern ICU and hospital treatment of acutely ill patients. Successful completion of the project will not only improve the treatment of many severely ill patients, it could help reduce the amount of health care resources spent without benefit. To accomplish this, we will use a unique and richly detailed 6,500-patient, 15-hospital data base which includes demographics, diagnosis, information on severity of illness (APACHE), therapeutic effort, and hospital outcome. There will be four specific aims: a. Identification of profiles of low-risk ICU patients whose disease and severity of illness indicate they could be adequately and safely treated outside an ICU. b. Provide physicians with improved objective prognostic ability concerning outcome from severe multi-organ system failure that could be used in clinical decision making. c. Invstigate the variations and estimate the incremental value of pulmonary artery catheterization amoung severely ill patients. d. Link this data base with DRG definitions and analyze the interhospital stability of cost per case within DRG categories of ICU admissions. In addition to the above aims, this project will also provide data processing and analytic support for hospitals who request assistance in improving their use of ICUs or evaluating outcome from treatment. This will help make the transition from research development of APACHE to its use by professionals in improving their use of modern hospital services.

对更好的工具的持续和日益增长的需求， 现代医疗保健的功效和有效性。 该项目将 扩展了APACHE（急性生理学和 慢性健康评估）疾病严重程度分类系统， 现代ICU与医院救治急性病的分析与研究 患者 项目的顺利完成不仅会改善 治疗许多重症患者，它可以帮助减少 卫生保健资源的浪费毫无益处。 为了做到这一点，我们将使用一个独特的和丰富的详细的6,500名患者， 15-医院数据库，包括人口统计、诊断、信息 根据疾病严重程度（APACHE）、治疗努力和医院结局。 将有四个具体目标： a. 低风险ICU患者的特征识别， 疾病严重程度表明他们可以得到充分和安全的治疗 在重症监护室外 B. 为医生提供更好的客观预后能力 关于严重多器官系统衰竭的结局， 用于临床决策。 C. 调查的变化和估计的增量价值 肺动脉导管插入术对重症患者的帮助。 D. 将此数据库与DRG定义链接，并分析医院间 ICU入院DRG类别内每例费用的稳定性。 除上述目标外，该项目还将提供数据， 为请求协助的医院提供处理和分析支持， 改善他们对ICU的使用或评估治疗结果。 这 将有助于从APACHE的研究开发过渡到其 专业人员使用，以改善他们对现代医院服务的使用。

项目成果

Identification of low-risk monitor patients within a medical-surgical intensive care unit.

识别内外科重症监护病房内的低风险监测患者。

• DOI: 10.1097/00005650-198304000-00005
• 发表时间: 1983
• 期刊: Medical care
• 影响因子: 3
• 作者: Wagner,DP;Knaus,WA;Draper,EA;Zimmerman,JE
• 通讯作者: Zimmerman,JE

African-American and white patients admitted to the intensive care unit: is there a difference in therapy and outcome?

入住重症监护室的非裔美国人和白人患者：治疗和结果有差异吗？

• DOI: 10.1097/00003246-199504000-00009
• 发表时间: 1995
• 期刊: Critical care medicine
• 影响因子: 8.8
• 作者: Williams,JF;Zimmerman,JE;Wagner,DP;Hawkins,M;Knaus,WA
• 通讯作者: Knaus,WA

A comparison of intensive care in the U.S.A. and France.

美国和法国重症监护的比较。

• DOI: 10.1016/s0140-6736(82)92748-9
• 发表时间: 1982
• 期刊: Lancet (London, England)
• 作者: Knaus,WA;LeGall,JR;Wagner,DP;Draper,EA;Loirat,P;Campos,RA;Cullen,DJ;Kohles,MK;Glaser,P;Granthil,C;Mercier,P;Nicolas,F;Nikki,P;Shin,B;Snyder,JV;Wattel,F;Zimmerman,JE
• 通讯作者: Zimmerman,JE

Identification of low-risk monitor admissions to medical-surgical ICUs.

识别入院内外科 ICU 的低风险监测者。

• DOI: 10.1378/chest.92.3.423
• 发表时间: 1987
• 期刊: Chest
• 影响因子: 9.6
• 作者: Wagner,DP;Knaus,WA;Draper,EA
• 通讯作者: Draper,EA

Do objective estimates of chances for survival influence decisions to withhold or withdraw treatment? The French Multicentric Group of ICU Research.

对生存机会的客观估计是否会影响停止或撤回治疗的决定？

• DOI: 10.1177/0272989x9001000303
• 发表时间: 1990
• 期刊: Medical decision making : an international journal of the Society for Medical Decision Making
• 作者: Knaus,WA;Rauss,A;Alperovitch,A;LeGall,JR;Loirat,P;Patois,E;Marcus,SE
• 通讯作者: Marcus,SE