ICU Scoring Systems


Severity scoring systems are commonly used in critical care and, when applied to the populations for whom they were developed and validated, these tools can inform mortality prediction and risk stratification, resource utilization, and optimization of patient outcomes.

Original articles published in the English language were identified through MEDLINE literature searches conducted for the years 1980 to 2020. A list of terms associated with critical care scoring systems were used alone or in combination for the literature search.

This article appraises the characteristics and applications of the scoring systems most frequently applied to critically ill patients: those that predict risk of in-hospital mortality at time of ICU admission (APACHE, SAPS, and MPM), and those that assess and characterize current degree of organ dysfunction (MODS, SOFA, and LODS). Variable type and collection timing, score calculation, patient population, and comparative performance data of these systems are detailed.

Awareness of the strengths, limitations, and specific characteristics of severity scoring systems commonly used in ICU patients is vital for critical care nurses to effectively employ these tools in clinical practice and to critically appraise research findings based on their usage.

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