The ability to effect change presupposes an ability to measure, describe, and predict. In the greater world outside the boundaries of the ICU, measurement and behavior are inextricably linked. I change my socks because I have worn them for a day, and carry an umbrella when it threatens to rain. The government changes when a rival party gains more votes than the party in power, and the melange of attitudes that create a culture change through the interplay of the events and perceptions that comprise our daily existence. The ability to measure, and to make a decision based on an awareness of the value of that measure, is fundamental to survival. I fight because my intuitive measurements tell me I am likely to win, and flee when they suggest that victory is improbable.
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References
Knaus WA, Wagner DP, Lynn J (1991) Short-term mortality predictions for critically ill hospitalized adults: science and ethics. Science 254:389–394
Safar P, DeKornfeld T, Pearson J, Redding JS (1961) The intensive care unit. A three year experience at Baltimore city hospitals. Anesthesia 16:275–284
Hickling KG, Walsh J, Henderson S, Jackson R (1994) Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hyper-capnia: A prospective study. Crit Care Med 22:1568–1578
Zaloga GP, Roberts P (1994) Permissive underfeeding. New Horiz 2:257–263
Hebert PC, Wells G, Blajchman MA, et al (1999) A multicentre randomized controlled clinical trial of transfusion requirements in critical care. N Engl J Med 340:409–417
Shoemaker WC, Appel PL, Kram HB, Waxman K, Lee TS (1988) Prospective trial of supranormal values of survivors as therapeutic goals in high risk surgical patients. Chest 94:1176–1186
Cook DJ, Brun-Buisson C, Guyatt GH, Sibbald WJ (1994) Evaluation of new diagnostic technologies: Bronchoalveolar lavage and the diagnosis of ventilator-associated pneumonia. Crit Care Med 22:1314–1322
Jacobs P, Noseworthy TW (1990) National estimates of intensive care utilization and costs: Canada and the United States. Crit Care Med 18:1282–1286
Echt DS, Liebson PR, Mitchell LB, et al (1991) Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med 324:781–788
Hayes MA, Timmins AC, Yau EHS, Palazzo M, Hinds CJ, Watson D (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330:1717–1722
Grover R, Lopez A, Lorente J, et al (1999) Multicenter, randomized, placebo-controlled, double blind study of the nitric oxide synthase inhibitor 546C88: Effect on survival in patients with septic shock. Crit Care Med 27:A33 (Abst)
Le Gall J-R, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957–2963
Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829
Hebert PC (1997) Mortality as an outcome in sepsis trials. Sepsis 1:35–40
Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ (1995) Multiple organ dysfunction score: A reliable descriptor of a complex clinical outcome. Crit Care Med 23:1638–1652
Petros AJ, Marshall JC, van Saene HKF (1995) Is mortality an appropriate endpoint for clinical trials in critical illness? Lancet 345:369–371
Salkeld G, Cameron ID, Cumming RG, et al (2000) Quality of life related to fear of falling and hip fracture in older women: A time trade off study. Br Med J 320:341–346
Gurman GM, Roy-Shapira A, Weksler N, Fisher A, Almog Y (1999) Prior functional status is a predictor of outcome in critically ill patients. Crit Care Med 27:A27 (Abst)
Deitch EA (1992) Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg 216:117–134
Beal AL, Cerra FB (1994) Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. JAMA 271:226–233
Bone RC, Balk RA, Cerra FB, et al (1992) ACCP/SCCM Consensus Conference. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101:1644–1655
Skillman JJ, Bushneil LS, Goldman H, Silen W (1969) Respiratory failure, hypotension, sepsis, and jaundice. A clinical syndrome associated with lethal hemorrhage and acute stress ulceration in the stomach. Am J Surg 117:523–530
Tilney NL, Bailey GL, Morgan AP (1973) Sequential system failure after rupture of abdominal aortic aneurysms: an unsolved problem in postoperative care. Ann Surg 178:117–122
Baue AE (1975) Multiple, progressive, or sequential systems failure. A syndrome of the 1970s. Arch Surg 110:779–781
Polk HC, Shields CL (1977) Remote organ failure: a valid sign of occult intraabdominal infection. Surgery 81:310–313
Fry DE, Pearlstein L, Fulton RL, Polk HC (1980) Multiple system organ failure. The role of uncontrolled infection. Arch Surg 115:136–140
Meakins JL, Wicklund B, Forse RA, Mclean APH (1980) The surgical intensive care unit: current concepts in infection. Surg Clin North Am 60:117–132
Goris RJA, te Boekhorst TPA,Nuytinck JKS, Gimbrere JSF (1985) Multiple organ failure. Generalized autodestructive inflammation? Arch Surg 120:1109–1115
Marshall JC, Christou NV, Horn R, Meakins JL (1988) The microbiology of multiple organ failure. The proximal GI tract as an occult reservoir of pathogens. Arch Surg 123:309–315
Vincent JL, Moreno R, Takala J, et al (1996) The sepsis-related organ failure assessment (SOFA) score to describe organ dysfunction/failure. Intensive Care Med 22:707–710
Le Gall JR, Klar J, Lemeshow S, et al (1996) The logistic organ dysfunction system - A new way to assess organ dysfunction in the intensive care unit. JAMA 276:802–810
Marshall JC, Bernard G, Le Gall J-R, Vincent J-L (1997) The measurement of organ dysfunction/failure as an ICU outcome. Sepsis 1:41–57
Marshall JC (1995) Multiple organ dysfunction syndrome (MODS). In: Sibbald WJ, Vincent JL (eds) Clinical Trials for the Treatment of Sepsis. Springer-Verlag, Berlin, pp 122–138
Keene AR, Cullen DJ (1983) Therapeutic intervention scoring system: Update 1983. Crit Care Med 11:1–3
Barie PS, Hydo LJ (1996) Influence of multiple organ dysfunction syndrome on duration of critical illness and hospitalization. Arch Surg 131:1318–1324
Vincent JL, De Mendonca A, Cantraine F, et al (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Crit Care Med 26:1793–1800
Maziak DE, Lindsay TF, Marshall JC, Walker PM (1998) The impact of multiple organ dysfunction on mortality following ruptured abdominal aortic aneurysm repair. Ann Vase Surg 12:93–100
Moreno R, Vincent JL, Matos R, et al (1999) The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Intensive Care Med 25:686–696
Bernard GR, Wheeler AP, Russell JA, et al (1997) The effects of ibuprofen on the physiology and survival of patients with sepsis. N Engl J Med 336:912–918
Marshall JC (1999) Charting the course of critical illness: Prognostication and outcome description in the intensive care unit. Crit Care Med 27:676–678
Staubach KH, Schröder J, Stüber F, Gehrke K, Traumann E, Zabel P (1998) Effect of pentoxifylline in severe sepsis. Results of a randomized, double-blind, placebo-controlled study. Arch Surg 133:94–100
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Marshall, J.C. (2002). Measuring Treatment Outcomes in Intensive Care: Mortality, Morbidity, and Organ Dysfunction. In: Sibbald, W.J., Bion, J.F. (eds) Evaluating Critical Care. Update in Intensive Care Medicine, vol 35. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56719-3_6
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