Chargement de votre page…
Journal of Clinical Medicine
Par P. Liberski, Szymon Czajka, Krzysztof Żerdziński et 1 autres.
Contenu en anglais
Prognosis prediction in adult intensive care units (ICUs) guides clinical decision-making, realistic goal-setting with families, and resource allocation, but is challenged by the marked heterogeneity of critically ill patients in multi-speciality wards.
Ward réunit ces articles dans la même app que vos cartes et vos questions. Un seul compte gratuit pour Ward, Suture, Osler et Prognia.
This narrative review critically analyses commonly used prognostic scoring systems by clinical application timeline.
Admission prognostic models, including the Acute Physiology and Chronic Health Evaluation (APACHE II/III/IV), Simplified Acute Physiology Score (SAPS II/SAPS 3) and Mortality Probability Model (MPM), estimate in-hospital mortality from acute physiological derangement and comorbidity; the Clinical Frailty Scale (CFS) adds prognostic value. During the ICU stay, organ dysfunction is tracked with the Sequential Organ Failure Assessment (SOFA/SOFA-2), designed for repeated reassessment, and the Multiple Organ Dysfunction Score (MODS), while the Therapeutic Intervention Scoring System (TISS-28) quantifies nursing workload. At discharge, the Barthel Index, Glasgow Outcome Scale (GOS) and Cerebral Performance Category (CPC) measure functional independence and neurological outcome. Admission-based mortality models use an initial assessment window and may require local recalibration, and discrimination alone does not establish clinical utility.
Future directions include trajectory-based models, phenotyping, biomarkers, time-limited trials and machine learning. Prognostic estimates should inform multidisciplinary evaluation and shared decision-making, rather than independently determine treatment intensity or withdrawal.
Publié dans Journal of Clinical Medicine. Le résumé est reproduit tel qu’il a été publié et reste l’œuvre de ses auteurs ; lisez l’article complet à la source.
Prognia référence cet article à des fins de documentation et de formation. Il ne constitue pas un avis médical. Lisez toujours l’original et suivez les recommandations en vigueur et les protocoles locaux avant d’agir.
