• M H Kollef and B T Allen.
• Department of Internal Medicine, Washington University School of Medicine, St. Louis, Mo 63110, USA.
• South. Med. J. 1997 Apr 1; 90 (4): 405-12.

AbstractTo prospectively validate a previously developed two-factor logistic regression model as a predictor of mortality, we studied its effectiveness in predicting outcome for patients in medical intensive care units (ICUs) who had surgical laparotomy. A high-risk classification was assigned to patients with an Organ System Failure Index (OSFI) > or = 3 or an APACHE (Acute Physiology and Chronic Health Evaluation) II score > 18 within 24 hours of surgery. The in-hospital mortality rate of surgical patients classified as high risk (n = 32) was significantly greater than that of surgical patients classified as low risk (n = 42) (62.5% versus 9.5%; relative risk, 6.6; 95% confidence interval, 2.5 to 17.3). Mortality after surgery correlated with presence or absence of the two variables from the logistic regression model: neither present, 9.5%; APACHE II > 18 present, 68.0%; OSFI > or = 3 present, 75.0%; both present, 88.2%. We showed that a two-factor risk classification at the time of surgical evaluation can be used to stratify medical ICU patients according to risk of in-hospital mortality.

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