Higgins Thomas L, Teres Daniel, Nathanson Brian
Baystate Medical Center, Critical Care Division, Springfield, MA, USA.
Curr Opin Crit Care. 2008 Oct;14(5):498-505. doi: 10.1097/MCC.0b013e3283101643.
The comparison of morbidity, mortality, and length-of-stay outcomes in patients receiving critical care requires adjustment based on their presenting illness. These adjustments are made with severity-of-illness models. These models must be periodically updated to reflect current medical practices. This article will review the history of the Mortality Probability Model (MPM), discuss why and how it was recently updated, and outline examples of MPM use.
All severity-of-illness models have limitations, especially if a unit's patient population becomes highly specialized. In these situations, customized models may provide better accuracy. The MPMs include those calculated at admission (MPM0) and additional models at 24, 48, and 72 h (MPM 24, MPM 48, and MPM 72). The model is now in its third iteration (MPM 0-III). Length of stay (LOS) and subgroup models have also been developed.
Understanding appropriate application of models such as MPM is important as transparency in healthcare drives demand for severity-adjusted outcomes data.
对接受重症监护的患者的发病率、死亡率和住院时间结局进行比较时，需要根据其初始疾病进行调整。这些调整通过疾病严重程度模型来进行。这些模型必须定期更新以反映当前的医疗实践。本文将回顾死亡率概率模型（MPM）的历史，讨论其近期更新的原因和方式，并概述MPM的使用示例。
所有疾病严重程度模型都有局限性，特别是当一个科室的患者群体变得高度专业化时。在这些情况下，定制模型可能会提供更高的准确性。MPM包括入院时计算的模型（MPM0）以及24、48和72小时时的其他模型（MPM 24、MPM 48和MPM 72）。该模型目前处于第三次迭代（MPM 0-III）。还开发了住院时间（LOS）和亚组模型。
了解诸如MPM等模型的适当应用很重要，因为医疗保健中的透明度推动了对经严重程度调整的结局数据的需求。
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