SURvival PRediction In SEverely Ill Patients Study—The Prediction of Survival in Critically Ill Patients by ICU Physicians

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Critically ill patients (n=3140). Intervention: Surprise question ('Would I be surprised if this patient died in the next 12 months?'). Primary outcome: Mean accuracy of the surprise question for predicting 1-year survival (Accuracy 81%, 95% CI 80-82).

Marijke M. Ros; Hester J. van der Zaag–Loonen; José G.M. Hofhuis; Peter E. Spronk

doi:10.1097/cce.0000000000000317

January 1, 2021Critical Care ExplorationsOpen Access

SURvival PRediction In SEverely Ill Patients Study—The Prediction of Survival in Critically Ill Patients by ICU Physicians

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Key result

The surprise question answered by ICU physicians within 2 hours of admission predicted 1-year survival with a mean accuracy of 81% and a negative predictive value of 86%.

Why the study?

During ICU admission, identifying which patients might or might not benefit from intensive treatment is important.

Does the surprise question accurately predict survival in critically ill patients admitted to the ICU?

Study Design

Type

Observational (n=3,140)

Multicenter

No

Structured PICO

Does the surprise question accurately predict survival in critically ill patients admitted to the ICU?

P

Population

3,140 critically ill adults (mean age 63.5 years, 43% female) admitted to a single-center ICU in the Netherlands, followed for 1 year to assess survival.

E

Exposure

Physician answering three surprise questions regarding expected survival of ICU admission, hospital stay, and 1 year after ICU admission.

O

Outcome

Positive and negative predictive values, mean accuracy, and kappa statistics of the surprise questions for ICU survival, hospital survival, and 1-year survival.hard clinical

Main Result

Effect estimate: Accuracy 81% (95% CI 80-82)

Limitations

Missing surprise question data led to the exclusion of 50 patients who had significant baseline differences.
Lack of a validation cohort to test the results of the prognostic model.
Single-center study design in the Netherlands may limit generalizability due to differences in ICU admission policies, capacity, and local ethical regulations.

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Answers are grounded in this paper and cite their sources.

Implication

The surprise question is a simple, inexpensive, and useful tool with high negative predictive value for evaluating the prognosis of acutely admitted critically ill patients.

Abstract

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Discussion

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Cite This Study

Ros et al. (2021) conducted an observational in Critically ill patients (n=3,140). Surprise question ('Would I be surprised if this patient died in the next 12 months?') was evaluated on Mean accuracy of the surprise question for predicting 1-year survival (Accuracy 81%, 95% CI 80-82). The surprise question answered by ICU physicians within 2 hours of admission predicted 1-year survival with a mean accuracy of 81% and a negative predictive value of 86%.

synapsesocial.com/papers/6a9a59d7c66c36f938debec3 https://doi.org/10.1097/cce.0000000000000317

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SURvival PRediction In SEverely Ill Patients Study—The Prediction of Survival in Critically Ill Patients by ICU Physicians

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

SURvival PRediction In SEverely Ill Patients Study—The Prediction of Survival in Critically Ill Patients by ICU Physicians

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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