ISSN:
1432-1238
Keywords:
Scoring systems
;
CCS
;
TISS
;
APS
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract There are no reports analyzing the results of pediatric intensive care in Europe. We evaluated quantitatively the severity of illness and the amount of care required for 714 consecutively admitted patients. We used simultaneously the Clinical Classification System (CCS) the Acute Physiology Score (APS) and the Therapeutic Intervention Scoring System (TISS). Overall mortality at 1 month was 15%. The mortality rate was higher for CCS Class IV patients (32.3%) than for CCS III (4.5%) and CCS II (3.2%). The difference was significant between CCS IV and CCS III and II respectively (p〈0.001) but no difference was observed between CCS III and CCS II. The patients were also classified among 7 major organ system failures: cardio vascular, respiratory, neurologic, gastro intestinal, renal, metabolic, hematologic. Three of them were primarily involved: respiratory (44.9%) cardio-vascular (20.7%), neurologic (18.8%). Among these 3 groups the highest mortality was observed in cardio-vascular patients (p〈0.01 v.s. respiratory, p〈0.05 v.s. neurologic). The death rate was 22% among the 264 neonates, 9.7% among the 247 infants (p〈0.01) and 12.6% among the 198 children. APS and TISS scores increased significantly with the CCS classes. However the overall mortality rate was 8% for the patients with an APS〈35 and 62.5% for the patients with an APS〉35 which probably represent the real class IV patients. Some discrepancies among the different institutions participating in the study suggest the need for further studies before the use of such score for interinstitutional comparisons and for evaluation of efficacy of therapy in multicenter studies.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00263562
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