This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rauss, A. Articles by Loirat, P. Search for Related Content PubMed PubMed Citation Articles by Rauss, A. Articles by Loirat, P. Social Bookmarking                         What's this?

Prognosis for Recovery from Multiple Organ system failure

The Accuracy of Objective Estimates of Chances for Survival

William A. Knaus, MD

Elizabeth Patois, PhD

Jean-Roger Le Gall, MD

Philippe Loirat, MD

This study evaluated the accuracy and reliability of predictions for recovery from multiple organ system failure (OSF). A previous analysis had provided estimates of the probabilities of recovery from various combinations of OSF for 2,843 intensive care unit (ICU) patients treated in 13 U.S. hospitals. These estimates were applied prospectively to 2,405 ICU admissions in 27 French hospitals. Despite variations in the incidences of underlying disease and the distributions of OSF between the two countries, clinical outcomes were similar for the 5,248 total patients. In both countries, two OSFs persisting for more than one day resulted in a hospital death rate of 60%. Hospital mortality rates for patients with three or more OSFs persisting after one day consistently exceeded 90%. Isolated neurologic failure had the poorest overall prognosis, but various other combinations of OSFs did not result in signifi cantly different outcomes. The stability of the prognostic estimates in the two countries suggests that, despite pathogenetic variations, persistent multiple OSF results in consistent clinical outcomes. These mortality projections provide firm reference data for assessing efficacy of new treatments within institutions with similar standards of care. The narrow confidence intervals associated with these estimates also provide objectively defined op portunities to review future treatment plans for individual patients. Key words: prediction; mortality; outcome; prognosis; organ system failure. (Med Decis Making 1990;10:155-162)

Medical Decision Making, Vol. 10, No. 3, 155-162 (1990)
DOI: 10.1177/0272989X9001000302


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J.-R. Le Gall, J. Klar, S. Lemeshow, F. Saulnier, C. Alberti, A. Artigas, and D. Teres The Logistic Organ Dysfunction System: A New Way to Assess Organ Dysfunction in the Intensive Care Unit JAMA, September 11, 1996; 276(10): 802 - 810. [Abstract] [PDF]

				L. Esserman, J. Belkora, and L. Lenert Potentially Ineffective Care: A New Outcome to Assess the Limits of Critical Care JAMA, November 15, 1995; 274(19): 1544 - 1551. [Abstract] [PDF]

				The National Committee for the Evaluation of Cento The French National Registry of HA-1A (Centoxin) in Septic Shock: A Cohort Study of 600 Patients Arch Intern Med, November 14, 1994; 154(21): 2484 - 2491. [Abstract] [PDF]

				D. H. Hickam Do Severity of Disease Classification Tools Chance Patient Care? Med Decis Making, August 1, 1990; 10(3): 153 - 154. [PDF]