Yeh T S, Pollack M M, Ruttimann U E, Holbrook P R, Fields A I
Pediatr Res. 1984 May;18(5):445-51. doi: 10.1203/00006450-198405000-00011.
We developed a physiology-based scoring system, the Physiologic Stability Index (PSI) to assess severity of acute illness in the total population of pediatric Intensive Care Unit (ICU) patients. Thirty-four variables from seven physiologic systems were chosen, and the degree of abnormality of each variable was assigned a score reflecting the clinical importance of the derangements. Validity was demonstrated by comparing PSI to hospital mortality and to two other methods that reflect severity of illness, the Clinical Classification System (CCS) and the Therapeutic Intervention Scoring System ( TISS ). Four hundred and twenty-three consecutive admissions to a multidisciplinary ICU were followed daily. Patients classified into higher CCS classes had significantly higher PSI scores (P less than 0.001), and there was a highly significant correlation (P less than 0.001) between PSI and TISS scores. The linear-logistic regression of observed mortality versus PSI was highly significant (P less than 0.0001) and provided an excellent fit. Highly significant differences between survivors and nonsurvivors were observed for PSI scores (P less than 0.001), as well as for composite slopes of the regression of PSI scores versus days of care (P less than 0.001). These data demonstrate validity of the PSI scoring system.
我们开发了一种基于生理学的评分系统——生理稳定性指数（PSI），用于评估儿科重症监护病房（ICU）全体患者的急性疾病严重程度。我们从七个生理系统中选取了34个变量，并为每个变量的异常程度赋予一个分数，以反映紊乱情况的临床重要性。通过将PSI与医院死亡率以及另外两种反映疾病严重程度的方法——临床分类系统（CCS）和治疗干预评分系统（TISS）进行比较，证明了该系统的有效性。我们对一家多学科ICU连续收治的423例患者进行了每日随访。CCS分级较高的患者PSI评分显著更高（P<0.001），并且PSI与TISS评分之间存在高度显著的相关性（P<0.001）。观察到的死亡率与PSI的线性逻辑回归具有高度显著性（P<0.0001），且拟合度良好。在PSI评分方面（P<0.001），以及在PSI评分与护理天数的回归复合斜率方面（P<0.001），存活者与非存活者之间均观察到高度显著的差异。这些数据证明了PSI评分系统的有效性。
