Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Introduction
- Barriers to Best Practice
- Ward Round Structure
- Other Housekeeping Issues
- Conclusion
- Epidemiology of Infection in the ICU
- Mechanisms of Infection in the ICU
- Approach to Infection Control
- Prevention of Infection in the ICU
- Why Assess Perioperative Risk?
- How Do We Identify High-Risk Patients?
- Population-Based Risk Scores
- Individualised Risk Prediction Models
- Objective Functional Capacity Assessment
- Biomarkers
- Assessment of Frailty
- Limitations of Scoring Systems
- Introduction
- Validity
- Scoring Systems
- Considerations and Limitations
- Disease-Specific Scoring systems
- Introduction
- The Responsibility Spiral
- The Lead Clinician/Clinical Director
- The Importance of Communication in ICU
- Effective Communication with Patients and Their Representatives
- Maintaining Accurate, Legible Legal records
- Teamwork and Collaboration
- Ensuring Continuity of Care through Effective Handover of Clinical Information
- Supporting Clinical Staff outside ICU and Contribution of Appropriate Supervision, Training and Delegation
- Introduction
- Capacity
- Consent
- Best Interests
- Conflict Resolution
- Introduction
- Assessment of Capacity
- Competent Adults
- Adults who Lack Capacity
- Advance Care Plans
- Prolonged Disorders of Consciousness
- Do Not Attempt Cardiopulmonary Resuscitation
- Futile Medical Treatment
- Gross Negligence Manslaughter
- Resources and Rationing
- Introduction
- What Is CoBaTrICE?
- Educational Approaches
- Integration in Clinical Practice
- Conclusion
- 11.1 Leading the Daily Intensive Care Ward Round
- 11.2 Principles and Compliance with Local Infection Control Measures
- 11.3 Principles of Outcome Prediction, Prognostic Indicators and Treatment Intensity Scales and Limitations of Scoring Systems in Predicting Individual Patient Outcome
- 11.4 Scoring Systems for Severity of Illness in Critical Care
- 11.5 Managerial and Administrative Responsibilities of the Intensive Care Medicine Specialist
- 11.6 Communication in Intensive Care
- 11.7 Professional Relationships with Members of the Healthcare Team
- 11.8 Legal and Ethical Issues in Intensive Care
- 11.9 The Legal Framework
- 11.10 CoBaTrICE: The Importance of Learning Opportunities and Integration of New Knowledge in Clinical Practice
- Index
- References
11.4 - Scoring Systems for Severity of Illness in Critical Care
from Section 11 - Professionalism, Patient Safety, Governance and Health Systems Management
Published online by Cambridge University Press: 27 July 2023
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Introduction
- Barriers to Best Practice
- Ward Round Structure
- Other Housekeeping Issues
- Conclusion
- Epidemiology of Infection in the ICU
- Mechanisms of Infection in the ICU
- Approach to Infection Control
- Prevention of Infection in the ICU
- Why Assess Perioperative Risk?
- How Do We Identify High-Risk Patients?
- Population-Based Risk Scores
- Individualised Risk Prediction Models
- Objective Functional Capacity Assessment
- Biomarkers
- Assessment of Frailty
- Limitations of Scoring Systems
- Introduction
- Validity
- Scoring Systems
- Considerations and Limitations
- Disease-Specific Scoring systems
- Introduction
- The Responsibility Spiral
- The Lead Clinician/Clinical Director
- The Importance of Communication in ICU
- Effective Communication with Patients and Their Representatives
- Maintaining Accurate, Legible Legal records
- Teamwork and Collaboration
- Ensuring Continuity of Care through Effective Handover of Clinical Information
- Supporting Clinical Staff outside ICU and Contribution of Appropriate Supervision, Training and Delegation
- Introduction
- Capacity
- Consent
- Best Interests
- Conflict Resolution
- Introduction
- Assessment of Capacity
- Competent Adults
- Adults who Lack Capacity
- Advance Care Plans
- Prolonged Disorders of Consciousness
- Do Not Attempt Cardiopulmonary Resuscitation
- Futile Medical Treatment
- Gross Negligence Manslaughter
- Resources and Rationing
- Introduction
- What Is CoBaTrICE?
- Educational Approaches
- Integration in Clinical Practice
- Conclusion
- 11.1 Leading the Daily Intensive Care Ward Round
- 11.2 Principles and Compliance with Local Infection Control Measures
- 11.3 Principles of Outcome Prediction, Prognostic Indicators and Treatment Intensity Scales and Limitations of Scoring Systems in Predicting Individual Patient Outcome
- 11.4 Scoring Systems for Severity of Illness in Critical Care
- 11.5 Managerial and Administrative Responsibilities of the Intensive Care Medicine Specialist
- 11.6 Communication in Intensive Care
- 11.7 Professional Relationships with Members of the Healthcare Team
- 11.8 Legal and Ethical Issues in Intensive Care
- 11.9 The Legal Framework
- 11.10 CoBaTrICE: The Importance of Learning Opportunities and Integration of New Knowledge in Clinical Practice
- Index
- References
Summary
Key Learning Points
1. Predictive scoring systems can use physiological, clinical and laboratory data to predict critical care patient mortality.
2. Their use extends to enabling standardisation of research cohorts, comparing and auditing critical care units and triaging critical care provision.
3. The most commonly used general scoring systems worldwide are APACHE (Acute Physiology and Chronic Health Evaluation) II and SOFA (Sequential Organ Failure Assessment) scores.
4. All systems need to be validated for calibration and discrimination, and have the potential to become less accurate over time.
5. No one system is better than any other – all have advantages and disadvantages.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 749 - 751Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
Bouch, DC, Thompson, JP. Severity scoring systems in the critically ill. Contin Educ Anaesth Crit Care Pain 2008;8:181–5.CrossRefGoogle Scholar
Breslow, MJ, Badawi, O. Severity scoring in the critically ill: Part 1—interpretation and accuracy of outcome prediction scoring systems. Chest 2012;141:245–52.CrossRefGoogle ScholarPubMed
Breslow, MJ, Badawi, O. Severity scoring in the critically ill: Part 2: maximizing value from outcome prediction scoring systems. Chest 2012;141:518–27.Google Scholar
Kelley, MA. 2021. Predictive scoring systems in the intensive care unit. www.uptodate.com/contents/predictive-scoring-systems-in-the-intensive-care-unitGoogle Scholar
Vincent, J-L, Moreno, R. Clinical review: scoring systems in the critically ill. Crit Care 2010;14:207.Google Scholar