Bion J F, Edlin S A, Ramsay G, McCabe S, Ledingham I M
Br Med J (Clin Res Ed). 1985 Aug 17;291(6493):432-4. doi: 10.1136/bmj.291.6493.432.
Fifty consecutive critically ill patients transported between hospitals by a mobile intensive care team were assessed prospectively using a modification of the acute physiology and chronic health evaluation (APACHE II) sickness scoring system. Assessments were made before and after resuscitation, on return to base, and after 24 hours of intensive care. No patient died during transport. Twenty two patients died subsequently in hospital and 28 survived to return home. The mean score for the non-survivors before resuscitation was 21.7 and for the survivors 12.2 (p less than 0.0005). Among the non-survivors there was a significant fall in score with resuscitation but this did not alter their subsequent outcome. Neither group deteriorated during transport. The sickness score is a powerful method for determining prognosis, and employed longitudinally it may be useful in the assessment of treatment. It has important implications for the administration and organisation of regional intensive care services.
一个移动重症监护团队前瞻性地评估了50例在医院之间转运的连续危重症患者，采用了改良的急性生理学与慢性健康状况评估（APACHE II）疾病评分系统。在复苏前后、返回基地时以及重症监护24小时后进行评估。转运过程中无患者死亡。随后有22例患者在医院死亡，28例存活并回家。未存活者复苏前的平均评分为21.7，存活者为12.2（p<0.0005）。在未存活者中，复苏后评分显著下降，但这并未改变他们随后的结局。两组在转运过程中均未恶化。疾病评分是确定预后的有力方法，纵向使用时可能有助于评估治疗。它对区域重症监护服务的管理和组织具有重要意义。
