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[重症医学每日评估的评分系统。概述、当前可能性及对新进展的要求]

[Scoring systems for daily assessment in intensive care medicine. Overview, current possibilities and demands on new developments].

作者信息

Brenck F, Hartmann B, Mogk M, Junger A

机构信息

Klinik für Anaesthesiologie, Intensivmedizin, Schmerztherapie, Universitätsklinikum Giessen und Marburg, Standort Giessen, Rudolf-Buchheim-Strasse 7, 35392 Giessen.

出版信息

Anaesthesist. 2008 Feb;57(2):189-95. doi: 10.1007/s00101-007-1299-1.

Abstract

Scoring systems are a fixed element of modern diagnostics and are integrated in the diagnosis-related groups (DRG) billing system as well as quality assurance projects. The ongoing developments require classification according to the terms of use in order to maintain an overview of the numerous systems available. In the area of intensive care medicine scoring systems can be divided into admission scores and progress scores, whereby the scores for daily assessment can be further subdivided into five categories, depending on the target criteria: objective description of the grade of organ dysfunction, progression in intensive care therapy, evaluation of the degree of nursing care, determination of outcome/mortality risk, and grouping of patient collectives for clinical trials. In future developments it will be necessary to generate new strategies to adequately describe the progress of a patient. Not only will mortality be challenged as a target criterion but also the handling of missing data and the simplification of reality by categorization practised so far that can be found in all established scoring systems as far as calculation of predictive values regarding a defined result.

摘要

评分系统是现代诊断的一个固定组成部分,并被整合到诊断相关分组(DRG)计费系统以及质量保证项目中。不断的发展要求根据使用条款进行分类,以便对众多可用系统有一个总体了解。在重症医学领域,评分系统可分为入院评分和病情进展评分,其中每日评估的评分根据目标标准可进一步细分为五类:器官功能障碍程度的客观描述、重症监护治疗的进展、护理程度的评估、结局/死亡风险的确定以及临床试验患者群体的分组。在未来的发展中,有必要制定新的策略来充分描述患者的病情进展。作为目标标准,不仅死亡率将受到挑战,而且现有所有评分系统中关于定义结果的预测值处理中存在的缺失数据处理以及目前通过分类简化现实的做法也将受到挑战。

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