Lewandowski K, Lewandowski M
Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Charité, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Anaesthesist. 2003 Oct;52(10):965-87; quiz 988-9. doi: 10.1007/s00101-003-0550-7.
Scoring systems represent classification systems or point systems which have been designed for making quantitative statements regarding the severity of a disease, its prognosis, and its course. Furthermore, scores may serve the purposes of assessing therapies, of quality control and of quality assurance, and of an economic evaluation of intensive care. Like all measuring methods, scores are susceptible to failures and systematic mistakes. The clinical user should be well aware of these limitations. Generally, one would recommend only using scores which have been rigorously tested for their reliability, validity, and practicability. These include, but are not limited to, the updated versions of the APACHE, the SAPS, and the MPM. Although great strides have been made concerning development, verification, and clinical applicability, scores still exhibit a level of uncertainty which precludes their use in individual patients. Frequently, it may be of benefit to combine the more general scores with one or several organ dysfunction scores to determine the extent of functional impairment of specific organs. If, however, well-trained medical personnel apply tried and tested scoring systems, intensive care units will definitely gain a lot from it.
评分系统是指分类系统或积分系统,其设计目的是就疾病的严重程度、预后及其病程做出定量描述。此外,评分可用于评估治疗效果、进行质量控制和质量保证以及对重症监护进行经济学评估。与所有测量方法一样,评分容易出现失误和系统性错误。临床使用者应充分意识到这些局限性。一般来说,只推荐使用经过严格测试其可靠性、有效性和实用性的评分。这些包括但不限于急性生理与慢性健康状况评分系统(APACHE)、简化急性生理学评分(SAPS)和死亡率预测模型(MPM)的更新版本。尽管在开发、验证和临床适用性方面已经取得了很大进展,但评分仍然存在一定程度的不确定性,这使得它们无法用于个体患者。通常,将更通用的评分与一个或几个器官功能障碍评分相结合,以确定特定器官功能损害的程度可能会有所帮助。然而,如果训练有素的医务人员应用经过试验和测试的评分系统,重症监护病房肯定会从中受益匪浅。