Henning R J, McClish D, Daly B, Nearman H, Franklin C, Jackson D
Crit Care Med. 1987 Mar;15(3):264-9. doi: 10.1097/00003246-198703000-00019.
We reviewed the clinical characteristics and resource utilization of 391 medical (M) and 315 surgical (S) ICU patients. In general, MICU patients had more physiologic derangement, as determined by the admission, maximal, and average acute physiology scores (APS). SICU patients had more frequent therapeutic interventions as measured by admission, maximal, and average therapeutic intervention scoring system values. Notably, 40% of MICU and 30% of SICU patients never received any active interventions and were admitted strictly for monitoring purposes. Patients on admission with APS less than or equal to 10 had markedly shorter ICU stays, with almost 50% less treatment than patients with APS over 10. Fifty-six percent of patients with APS less than or equal to 10 did not require any active intervention. In contrast, 83% of patients with APS greater than 10 had considerable intensive interventions. These patients required mechanical ventilation, invasive monitoring, and vasoactive drugs more than twice as often as patients with lower APS scores. Consideration should be given, therefore, to the organization of ICUs according to the patient's severity of illness.
我们回顾了391例内科（M）重症监护病房患者和315例外科（S）重症监护病房患者的临床特征及资源利用情况。总体而言，根据入院时、最高及平均急性生理学评分（APS）判断，内科重症监护病房患者存在更多生理紊乱情况。以外科重症监护病房患者入院时、最高及平均治疗干预评分系统值衡量，其接受治疗性干预更为频繁。值得注意的是，40%的内科重症监护病房患者和30%的外科重症监护病房患者从未接受任何积极干预，入院仅为严格监测。入院时急性生理学评分小于或等于10分的患者重症监护病房住院时间明显更短，接受的治疗比急性生理学评分超过10分的患者少近50%。56%急性生理学评分小于或等于10分的患者不需要任何积极干预。相比之下，83%急性生理学评分大于10分的患者接受了大量强化干预。这些患者接受机械通气、有创监测及血管活性药物治疗的频率是急性生理学评分较低患者的两倍多。因此，应根据患者病情严重程度来考虑重症监护病房的设置。
