Evaluation of the usefulness of sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation III (APACHE III) scoring systems in outcomes prediction of critically ill cirrhotic patients

Abstract

he ability to objectively estimate patient risk for mortality or other important outcomes is a new undertaking for clinical research. Empirically based risk assessments for important clinical events have been extremely useful in evaluating new therapies, in monitoring resource utilization, and in improving quality assessment. Attempts at prediction, however, have been much less successful in forecasting individual patient risk or in reducing the uncertainty of daily clinical decision making. Objective risk estimates are particularly important in the high-cost, emotional, and technologically demanding environments of intensive care units (ICUs). Because of the high costs of ICUs, precise quality assurance and utilization management strategies are essential. Knowledge of the risk faced by a patient on the day of ICU admission could provide an empiric basis for quality assurance and utilization activities. Estimates during the course of therapy could be useful in investigating the optimal time for discharge or in deciding how long to continue therapy.