Universität zu Köln

Radtke, Anne, Pfister, Roman, Kuhr, Kathrin, Kochanek, Matthias and Michels, Guido (2017). Is 'gut feeling' by medical staff better than validated scores in estimation of mortality in a medical intensive care unit? - The prospective FEELING-ON-ICU study. J. Crit. Care, 41. S. 204 - 209. PHILADELPHIA: W B SAUNDERS CO-ELSEVIER INC. ISSN 1557-8615

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Abstract

Purpose: The aim of the FEELING-ON-ICU study was to compare mortality estimations of critically ill patients based on 'gut feeling' of medical staff and by Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA). Materials and methods: Medical staff estimated patients' mortality risks via questionnaires. APACHE II, SAPS II and SOFA were calculated retrospectively from records. Estimations were compared with actual in-hospital mortality using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). Results: 66 critically ill patients (60.6% male, mean age 63 +/- 15 years (range 30-86)) were evaluated each by a nurse (n = 66, male 32.4%) and a physician (n = 66, male 67.6%). 15 (22.7%) patients died on the intensive care unit. AUC was largest for estimations by physicians (AUC 0.814 (95% CI 0.705-0.923)), followed by SOFA (AUC 0.749 (95% CI 0.629-0.868)), SAPS II (AUC 0.723 (95% CI 0.597-0.849)), APACHE II (AUC 0.721 (95% CI 0.595-0.847)) and nursing staff (AUC 0.669 (95% CI 0.529-0.810)) (p < 0.05 for all results). Conclusions: The concept of physicians' 'gut feeling' was comparable to classical objective scores inmortality estimations of critically ill patients. Concerning practicability physicians' evaluations were advantageous to complex score calculation. (C) 2017 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Radtke, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-215085
DOI:	10.1016/j.jcrc.2017.05.029
Journal or Publication Title:	J. Crit. Care
Volume:	41
Page Range:	S. 204 - 209
Date:	2017
Publisher:	W B SAUNDERS CO-ELSEVIER INC
Place of Publication:	PHILADELPHIA
ISSN:	1557-8615
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CRITICALLY-ILL PATIENTS; APACHE-II; HOSPITAL MORTALITY; SAPS-II; ORGAN DYSFUNCTION/FAILURE; ACUTE PHYSIOLOGY; SOFA SCORE; SYSTEM; MULTICENTER; PATIENT Multiple languages Critical Care Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21508