Articles: critical-illness.
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To examine the attitudes of health care workers regarding the withdrawal of life support. ⋯ While ICU health care workers consistently identify a number of patient factors as important in decisions to withdraw care, there is extreme variability, which may be explained in part by the values of individual health care providers.
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Se Asian J Trop Med · Mar 1995
Comparative StudyScoring systems for predicting outcomes of critically ill patients in northeastern Thailand.
The Acute Physiology and Chronic Health Evaluation System (APACHE) III, the APACHE II, the Simplified Acute Physiology Score (SAPS), and the Therapeutic Intervention Scoring System (TISS), calculated within the first 24 hours of admission, were compared in 209 critically ill patients admitted to the regional hospital in northeastern Thailand. Eighty-five (40.7%) patients subsequently died. The nonsurvivors had significantly higher APACHE III, APACHE II, SAPS and TISS scores than the survivors. ⋯ All four scoring system correlated well with the short-term prognosis, ie the mortality outcome, of critically ill patients. APACHE III, APACHE II, SAPS, and TISS appeared to be comparable to predictors of severity of critical illness. Selection of a severity indicator will depend on the resources available.
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Intensive care medicine · Mar 1995
Comparative Study Retracted PublicationAlterations in circulating vasoactive substances in the critically ill--a comparison between survivors and non-survivors.
Regulation of circulatory homeostasis is based on several factors including various circulating vasoactive substances. Whether these regulators differ between survivors and non-survivors was investigated in critically ill patients. ⋯ Systemic and regional regulators of the circulation were markedly changed by critical illness. In survivors, these regulators almost normalized within the study period of 5 days, whereas in non-survivors these alterations were even aggravated. It can only be speculated whether these regulator systems were influenced by activation of various mediator systems or whether they themselves influenced the negative outcome in the non-survivors.
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Multicenter Study Clinical Trial
The SUPPORT prognostic model. Objective estimates of survival for seriously ill hospitalized adults. Study to understand prognoses and preferences for outcomes and risks of treatments.
To develop and validate a prognostic model that estimates survival over a 180-day period for seriously ill hospitalized adults (phase I of SUPPORT [Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments]) and to compare this model's predictions with those of an existing prognostic system and with physicians' independent estimates (SUPPORT phase II). ⋯ A limited amount of readily available clinical information can provide a foundation for long-term survival estimates that are as accurate as physicians' estimates. The best survival estimates combine an objective prognosis with a physician's clinical estimate.