Critical care : the official journal of the Critical Care Forum
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Comparative Study
Assessment of six mortality prediction models in patients admitted with severe sepsis and septic shock to the intensive care unit: a prospective cohort study.
We conducted the present study to assess the validity of mortality prediction systems in patients admitted to the intensive care unit (ICU) with severe sepsis and septic shock. We included Acute Physiology and Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, Mortality Probability Model (MPM) II0 and MPM II24 in our evaluation. In addition, SAPS II and MPM II24 were customized for septic patients in a previous study, and the customized versions were included in this evaluation. ⋯ Although general ICU mortality system models had accurate overall mortality prediction, they had poor calibration. Customization of SAPS II and, to a lesser extent, MPM II24 improved calibration. The customized model may be a useful tool when evaluating outcomes in patients with sepsis.
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The encouraging results of recent clinical trials on therapy of severe sepsis and septic shock are paralleled by ongoing studies on the epidemiology of sepsis and infection in intensive care unit patients all over the world. The development of network-based systems for assessing morbidity and mortality in intensive care unit patients has contributed to a significant improvement in quality of care. Data from the SOAP (Sepsis Occurrence in the Acutely Ill Patient) study demonstrate that the treatment of septic patients varies widely, and that even those strategies that have been evaluated are not yet implemented in routine practice. Hence, activities on surveillance and education still merit further attention.