Case mix, outcomes and comparison of risk prediction models for admissions to adult, general and specialist critical care units for head injury: a secondary analysis of the ICNARC Case Mix Programme Database.pdf (749.16 kB)
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Case mix, outcomes and comparison of risk prediction models for admissions to adult, general and specialist critical care units for head injury: a secondary analysis of the ICNARC Case Mix Programme Database.

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journal contribution
posted on 15.10.2019, 11:29 by Jonathan A. Hyam, Catherine A. Welch, David A. Harrison, David K. Menon
INTRODUCTION: This report describes the case mix and outcome (mortality, intensive care unit (ICU) and hospital length of stay) for admissions to ICU for head injury and evaluates the predictive ability of five risk adjustment models. METHODS: A secondary analysis was conducted of data from the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme, a high quality clinical database, of 374,594 admissions to 171 adult critical care units across England, Wales and Northern Ireland from 1995 to 2005. The discrimination and calibration of five risk prediction models, SAPS II, MPM II, APACHE II and III and the ICNARC model plus raw Glasgow Coma Score (GCS) were compared. RESULTS: There were 11,021 admissions following traumatic brain injury identified (3% of all database admissions). Mortality in ICU was 23.5% and in-hospital was 33.5%. Median ICU and hospital lengths of stay were 3.2 and 24 days, respectively, for survivors and 1.6 and 3 days, respectively, for non-survivors. The ICNARC model, SAPS II and MPM II discriminated best between survivors and non-survivors and were better calibrated than raw GCS, APACHE II and III in 5,393 patients eligible for all models. CONCLUSION: Traumatic brain injury requiring intensive care has a high mortality rate. Non-survivors have a short length of ICU and hospital stay. APACHE II and III have poorer calibration and discrimination than SAPS II, MPM II and the ICNARC model in traumatic brain injury; however, no model had perfect calibration.

Funding

This study was supported by ICNARC. The authors wish to thank everyone in the critical care units participating in the CMP [47]. We acknowledge the Department of Health and the Welsh Health Common Services Authority for the initial, two-year, pump-priming funds in 1994 to establish ICNARC.

History

Citation

Critical Care, 2006, volume 10, Article number: S2

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

Critical Care

Publisher

BMC (part of Springer Nature), Critical Care Canada Forum (CCCF), International Symposium on Intensive Care and Emergency Medicine (ISICEM)

eissn

1466-609X

Acceptance date

12/10/2006

Copyright date

2006

Available date

15/10/2019

Publisher version

https://ccforum.biomedcentral.com/articles/10.1186/cc5066

Language

en