PREDICTIVE SCORING SYSTEM FOR SELECTED COMPLICATIONS OF ICU PATIENTS.
Contributors: Rush University, College Of Nursing.
Published: 1991
Number of pages: 184
Subjects: Health Sciences, Medicine and Surgery.; Health Sciences, Nursing.; Health Sciences, Nutrition.
Description: The purpose of this study was to evaluate the predictability of complication state by indicators of illness state, nutritional status, and energy balance. Illness state was defined as physiological derangement and was measured by APACHE II scores. Nutritional status was defined as structural and functional effects of nutrients and was measured by percentages of ideal body weight, serum albumin levels, and total lymphocyte counts. Energy balance was defined as the difference between caloric intake and energy requirement and was calculated in that way. The sample consisted of 150 American and 70 Chinese adults who stayed in ICU longer than 3 days, not pregnant, not amputees, and not diagnosed as leukemia. The sample yielded 2,587 observations. Subjects were randomly assigned to two groups, one for developing and one for validating the predictive scoring system. Data were analyzed using discriminant analysis. Parameters found to be predictive were the indicators measured upon ICU admission and two days prior to the presence or resolution of complications.

The predictive scoring system assigned points to each measure of the predictors and used a reference criteria for making predictions. The predictive patterns are similar in the American and the Chinese group, but the predictions are more accurate for the American group than for the Chinese group. The predictions found to be effective in this study were: predicting presence of respiratory failure, pneumonia, sepsis, and pressure sores for the American group; predicting presence of respiratory failure and pneumonia in the Chinese group; predicting resolution of respiratory failure and pneumonia in the American group, and predicting resolution of respiratory failure in the Chinese group. The predictions are more accurate for medical patients than for surgical patients, and are more accurate for short-term observations than for long-term observations. Coexisting complications may account for the differences and will be investigated in the future studies. The current study recommend clinical application of this predictive scoring system to increase ICU nurses' involvement in complication assessment and management.
Notes: Source: Dissertation Abstracts International, Volume: 52-03, Section: B, page: 1343.

Thesis (D.N.SC.)--RUSH UNIVERSITY, COLLEGE OF NURSING, 1991.

School code: 0591.