- Section 1 ICU organization and management
- Part 1.1 The intensive care unit
- Part 1.2 Communication
- Part 1.3 Training
- Part 1.4 Safety and quality
- Part 1.5 Governance
- Part 1.6 Research
- Part 1.7 Medico-legal and ethical issues
- Part 1.8 Critical illness risk prediction
- Chapter 28 The role and limitations of scoring systems
- Chapter 29 Severity of illness scoring systems
- Chapter 30 Organ failure scoring
- Chapter 31 Genetic and molecular expression patterns in critical illness
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 125) Severity of illness scoring systems
- Chapter:
- (p. 125) Severity of illness scoring systems
- Author(s):
Graeme K. Hart
and David Pilcher
- DOI:
- 10.1093/med/9780199600830.003.0029
Clinical outcome comparisons for research and quality assurance require risk adjustment measures validated in the population of interest. There are many scoring systems using intensive care unit (ICU)-specific or administrative data sets, or both. Risk-adjusted ICU and hospital mortality outcome measures may be not granular enough or may be censored before the absolute risk of the studied outcome reaches that of the population at large. Data linkage methods may be used to examine longer-term outcomes. Organ failure scores provide a method for assessing the intra-episode time course of illness and scores using treatment variables may be useful for assessing care requirements. Each adjustment system has specific merits and limitations, which must be understood for appropriate use. Graphical representations of the comparisons facilitate understanding and time-appropriate response to variations in outcome. There are, as yet, no universally-accepted measures for severity of illness and risk adjustment in deteriorating patients outside the ICU.
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- Section 1 ICU organization and management
- Part 1.1 The intensive care unit
- Part 1.2 Communication
- Part 1.3 Training
- Part 1.4 Safety and quality
- Part 1.5 Governance
- Part 1.6 Research
- Part 1.7 Medico-legal and ethical issues
- Part 1.8 Critical illness risk prediction
- Chapter 28 The role and limitations of scoring systems
- Chapter 29 Severity of illness scoring systems
- Chapter 30 Organ failure scoring
- Chapter 31 Genetic and molecular expression patterns in critical illness
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care