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Titolo:
The added value that increasing levels of diagnostic information provide in prognostic models to estimate hospital mortality for adult intensive carepatients
Autore:
de Keizer, NF; Bonsel, GJ; Goldfad, C; Rowan, KM;
Indirizzi:
Acad Med Ctr, Dept Med Informat, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands Acad Med Ctr, Dept Clin Epidemiol & Biostat, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands Intens Care Natl Audit & Res Ctr, London WC1H 9HR, England Intens Care Natl Audit & Res Ctr London England WC1H 9HR 1H 9HR, England
Titolo Testata:
INTENSIVE CARE MEDICINE
fascicolo: 5, volume: 26, anno: 2000,
pagine: 577 - 584
SICI:
0342-4642(200005)26:5<577:TAVTIL>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC HEALTH EVALUATION; ACUTE PHYSIOLOGY SCORE; SOCIETY APACHE-II; ICU PATIENTS; CLASSIFICATION-SYSTEM; PROBABILITY-MODELS; CASE-MIX; MULTICENTER; PREDICTION; BRITAIN;
Keywords:
intensive care; APACHE II; prognostic models; reason for admission; mortality;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: de Keizer, NF Acad Med Ctr, Dept Med Informat, J2-256,POB 22700, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr J2-256,POB 22700 Amsterdam Netherlands NL-1100 DE
Citazione:
N.F. de Keizer et al., "The added value that increasing levels of diagnostic information provide in prognostic models to estimate hospital mortality for adult intensive carepatients", INTEN CAR M, 26(5), 2000, pp. 577-584

Abstract

Objective:To investigate in a systematic, reproducible way the potential of adding increasing levels of diagnostic information to prognostic models for estimating hospital mortality. Design: Prospective cohort study. Setting: Thirty UK intensive care units (ICUs) participating in the ICNARCCase Mix Programme. Patients: Eight thousand fifty-seven admissions to UK ICUs. Measurements and results: Logistic regression analysis incorporating APACHE II score, admission type and increasing levels of diagnostic information was used to develop models to estimate hospital mortality for intensive care patients. The 53 UK APACHE II diagnostic categories were substituted withdata from a hierarchical, five-tiered (type of condition required surgery or not, body system, anatomical site, physiological/pathological process, condition) coding method, the ICNARC Coding Method. The inter-rater reliability using the ICNARC Coding Method to code reasons for admission was good (kappa = 0.70). All new models had good discrimination (AUC = 0.79-0.81) andsimilar or better calibration compared with the UK APACHE II model (Hosmer-Lemeshow goodness-of-fit H = 18.03 to H = 26.77 for new models versus H = 63.51 for UK APACHE II model). Conclusion: The UK APACHE II model can be simplified by extending the admission type and substituting the 53 UK APACHE II diagnostic categories with nine body systems, without losing discriminative power or calibration.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 20:53:35