Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Apr 2000
Severity scoring systems and the prediction of outcome from intensive care.
Severity scoring systems are tools that provide a predicted mortality for a group of intensive care unit patients on the basis of derangement of their physiology and some past medical history. This predicted mortality can then be compared with the actual mortality to give some indicator of the effectiveness of the package of care delivered by the intensive care unit, corrected for differences in case-mix. ⋯ This may be partly due to limitations in their ability to predict mortality outside the population on which they were developed, and to the change in calibration of the system with time and advances in medical science. This review briefly addresses the limitations of severity scoring systems in light of recent publications.
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Recent studies suggest that perioperative pulmonary aspiration is an infrequent event (approximately 1 : 2000-3000 general anesthetics), but its impact on individual patients can be devastating. Patients who appear to have the greatest risk of developing severe pulmonary morbidity or dying after aspiration are those who are sick (American Society of Anesthesiologists physical classification 3 or greater) and elderly. As a general rule, children have less morbidity from pulmonary aspiration.