Prognostic systems in intensive care: general principles, development, and clinical applications.

A V Carneiro, M Ivo, J Girão, F De Pádua, M G Lopes


In this review article, we present the need for prognostic scoring in clinical medicine, specially in Intensive Care Medicine (ICM). The general principles of prognostication in ICM are discussed, and three general scoring systems are presented: ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION (APACHE) in its 3 versions, SIMPLIFIED ACUTE PHYSIOLOGY SCORE (SAPS) and MORTALITY PREDICTION MODEL (MPM). The use of these prognostic systems is then evaluated not only as a support for medical decision-making, and resource allocation, but also as a tool for clinical studies in terms of patient randomization. Finally, the future developments and clinical application of these risk stratification systems are presented and discussed.

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