Knaus W A, Draper E A, Wagner D P, Zimmerman J E, Birnbaum M L, Cullen D J, Kohles M K, Shin B, Snyder J V
Crit Care Med. 1982 Aug;10(8):491-6. doi: 10.1097/00003246-198208000-00001.
To contrast mortality for groups of ICU patients treated in different hospitals, we surveyed 795 consecutive ICU admissions in 5 ICUs using a general severity of illness classification system. After obtaining information from the medical record on age, sex, indication for ICU admission, and severity of illness, we used a logistic multiple regression equation to project death rates for each ICU based on data from a sixth reference hospital. There were substantial differences in severity of acute illness among the hospitals which accounted for most of the variation in death rates. In all ICUs, however, projected death rates were quite similar to observed deaths. These findings suggest that the use of a general severity of illness index and multivariate statistical techniques could, after further refinement and validation, improve interhospital comparisons of the outcome of acutely ill patients.
为了对比在不同医院接受治疗的重症监护病房(ICU)患者群体的死亡率,我们使用一般疾病严重程度分类系统,对5个ICU的795例连续入住ICU的患者进行了调查。在从病历中获取有关年龄、性别、入住ICU的指征和疾病严重程度的信息后,我们使用逻辑多元回归方程,根据来自第六家参考医院的数据,预测每个ICU的死亡率。各医院急性疾病的严重程度存在很大差异,这是死亡率差异的主要原因。然而,在所有ICU中,预测死亡率与观察到的死亡情况非常相似。这些发现表明,在进一步完善和验证后,使用一般疾病严重程度指数和多变量统计技术可以改善对急性病患者治疗结果的医院间比较。