August 1, 2002Critical Care Medicine

Identifying potentially ineffective care in a community hospital*

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Why the study?

Can a model using APACHE III scores on day 1 and day 5 predict mortality between ICU day 5 and 100 days post-discharge in adult ICU patients?

Structured PICO

Can a model using APACHE III scores on day 1 and day 5 predict mortality between ICU day 5 and 100 days post-discharge in adult ICU patients?

Population

8,129 consecutive adult admissions to the intensive care unit (medical-surgical, cardiac-medical, and cardiac-surgical units) of an 850-bed community hospital, split into a development cohort (n=4,045) and a validation cohort (n=4,084).

Intervention

Prediction model using APACHE III predicted mortality on day 5 of >0.92 or the product of day 1 and day 5 APACHE predicted mortality of >0.40, with an increase in the APACHE predicted mortality from day 1 to day 5 of >0.10.

Outcome

Mortality between intensive care unit day 5 and 100 days after hospital dischargehard clinical

Limitations

Low sensitivity limits the number of patients for whom death at 100 days is predicted
Needs validation in diverse institutional settings

Discussion

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Implication

A prediction model using APACHE III scores from ICU days 1 and 5 can identify patients at high risk of mortality up to 100 days post-discharge with high specificity and positive predictive value, though sensitivity is low.

Cite This Study

Fleegler et al. (2002) studied this question.

synapsesocial.com/papers/6a1095f342b7486443ff208e https://doi.org/10.1097/00003246-200208000-00022

View Full Paper

Ask AI

Bookmark

Identifying potentially ineffective care in a community hospital*

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Identifying potentially ineffective care in a community hospital*

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider