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The role and limitations of scoring systems 

The role and limitations of scoring systems
Chapter:
The role and limitations of scoring systems
Author(s):

Hannah Wunsch

and Andrew A. Kramer

DOI:
10.1093/med/9780199600830.003.0028
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date: 20 February 2020

Scoring systems for critically-ill patients provide a measure of the severity of illness of patients admitted to intensive care units (ICUs). They are primarily based on patient characteristics, physiological derangement, and/or clinical assessments. Severity scores themselves allow for risk-adjusting outcomes, but they can also be used to provide a prediction of the overall risk of death, length of stay, or other outcome for critically ill patients. This allows for comparison of outcomes between different cohorts of patients or between observed and predicted ICU performance. There are a number of general ICU scoring systems that are in use. All scoring systems have limitations. Future scoring systems may include prediction of longer-term outcomes, and assimilation of granular data temporally and at the molecular level that could result in more personalized severity scores to help guide individual care decisions.

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