Comparison of two predictive models for prognosis in critically ill patients in a Veteran's Affairs Medical Center coronary care unit

E. S. Burnette, R. G. Wunderink*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Study objective: The acute physiologic and chronic health evaluation score has been developed to assess prognosis in critically ill patients. Knaus et al initially determined and validated diagnosis-specific coefficients for prediction of outcome in a group of multidisciplinary ICUs. Teskey et al found different coefficients for cardiac diagnoses in a retrospective analysis of coronary care unit (CCU) only patients. This study compares the actual mortality in a Veteran's Affairs Medical Center (VAMC) CCU with the mortality predicted by the two equations. Design and setting: Data were prospectively collected for patients admitted to the medical CCU at a university-affiliated, tertiary care VAMC. Patients: Patients (n=338) admitted to the CCU with the diagnoses of coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF), arrhythmia (Arr), and other cardiac-related diagnoses. Results: The entire CCU population showed no significant differences from either the predictions by Knaus et al and Teskey et al in 1991. However, when specific disease states were analyzed as a whole, significant differences from both prediction models for CAD and MI actual mortality were found. Teskey et al was a better predictor for the Art and CHF population, while both were equally reliable for other. Conclusions: Either prediction model is reliable for a CCU population in general. However, diagnosis-specific coefficients of Teskey et al appear to correlate better with actual mortality for this VAMC. Significant outcome differences compared with those predicted may reflect the patient population specific to a VAMC.

Original languageEnglish (US)
Pages (from-to)1333-1337
Number of pages5
JournalCHEST
Volume108
Issue number5
DOIs
StatePublished - Jan 1 1995

Keywords

  • APACHE II
  • Veteran's Affairs Medical Center
  • coronary care unit
  • mortality prediction

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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