PREDICTION OF OUTCOME, FROM INTENSIVE-CARE AFTER GASTROENTEROLOGIC EMERGENCY

Prognostic factors determining the outcome from intensive care were st udied in 952 patients admitted to 25 Finnish ICUs after gastroenterolo gic emergency. Logistic regression analysis was used to create predict ive models based on the APACHE, II-system, The models were constructed by using data from a random two-thirds of the study population and va lidated in the remaining independent one-third together with the origi nal APACHE II-index, The Acute Physiology Score, age, and a pre-existi ng liver disease were the three most important determinants of outcome . The inclusion of the TISS score describing the intensify of treatmen t into a model did not enhance the accuracy of the prediction. Our mod els were better calibrated than the original APACHE II-equation when t ested by the goodness-of-fit-statistics. These statistical models may help the clinicians to predict the outcome for an individual patient b y providing them information about the relative impacts of predictive Factors or about the probability of death. These probabilities should be interpreted cautiously, taking into acount the limitations of stati stical methods. This is especially important when assessing the highri sk patients. Their number in our study was too low for accurate outcom e prediction.