Lemeshow S, Teres D, Pastides H, Avrunin J S, Steingrub J S
Crit Care Med. 1985 Jul;13(7):519-25. doi: 10.1097/00003246-198507000-00001.
Data at ICU admission and after 24 h in the ICU were collected on 755 patients, to derive multiple logistic regression models for predicting hospital mortality. The derived models contained relatively few and easily obtained variables. The weight associated with each variable was determined objectively. There were seven admission variables, none of which were treatment dependent, and seven 24-h variables reflecting treatments and patients' conditions in the ICU. Predicted outcomes using these two models were closely correlated with actual outcome. Theoretically, a predictive model would be useful to physicians for triage decisions as well as determining aggressiveness of care through discussions with families, determining utilization of ICU facilities, and objectively comparing different ICUs. This research represents an initial attempt to develop models that are not based on subjectively determined weights.
收集了755例患者在重症监护病房(ICU)入院时及入住ICU 24小时后的资料,以建立预测医院死亡率的多重逻辑回归模型。所建立的模型包含的变量相对较少且易于获取。每个变量的权重是客观确定的。有7个入院变量,均与治疗无关,还有7个反映ICU治疗及患者状况的24小时变量。使用这两个模型预测的结果与实际结果密切相关。从理论上讲,预测模型对医生进行分诊决策、通过与家属讨论确定治疗的积极程度、确定ICU设施的使用情况以及客观比较不同的ICU都很有用。本研究是开发不基于主观确定权重的模型的初步尝试。