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Prognostic scoring systems and outcome

markers in ICU patients

Article in Archives of Hellenic Medicine September 2014

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4 authors, including:

Serafim N Nanas Pavlos Myrianthefs

National and Kapodistrian University of Ath National and Kapodistrian University of Ath
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Prognostic scoring systems and outcome markers in ICU patients
S. FIKA 1, S. NANAS1, G. BALTOPOULOS2, P.MYRIANTHEFS2
1
Intensive Care Unit, Evangelismos General Hospital of Athens, Athens, Greece
2
Intensive Care Unit, Agioi Anargyroi General Oncology Hospital in Kifissia, Athens,
Greece

The illness severity and outcome prediction scores for ICU patients were developed
approximately 30 years ago. They are very important in clinical practice as they are
widely used to predict the outcome, characterize the critical of illness, the degree of
organ dysfunction, assess the resource use and quantify the needs of the ICU. The
scoring systems can also be very valuable for evaluating the quality of care
(benchmarking) and for risk stratification or ensuring comparability of patient
populations in clinical trials. Many of these scoring systems have been updated and
should be in continuous progress in order to keep up with the population of the
patients whose the case-mix and the severity changes. APACHE (Acute Physiology
and Chronic Health Evaluation), MPM (mortality probability model), SAPS (simplified
acute physiology score) and SOFA (Sequential Organ Failure Assessment) are the
major generic ICU scoring systems in use today. Central to all these systems is the
use of physiological data of patients and that the differences in time of the data
selection may influence the accuracy of the systems. TISS (Therapeutic Intervention
Scoring System) and NAS (Nursing Activity Score) are the major scoring systems
widely used to assess nursing workload and in many researches are associated with
the severity of illness and the length of stay of ICU patients. Recently, there is a
great interest concerning some biochemical markers that their rate of changes
during the critical illness can predict the outcome. It may be possible in the future to
develop reliable prognostic models which will include the concentration of various
biological markers in order to assist clinical decision making.
Key words: outcome prediction, outcome markers, nursing workload, severity of
illness, intensive care