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Risk Prediction and Outcome Description in Critical Surgical Illness

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Abstract

The first half of the twentieth century brought a number of important advances in the ability of the surgeon to care for the critically ill or multiply injured patient. An understanding of the critical role of fluid resuscitation in the treatment of shock, the development of blood transfusion, the development of techniques to monitor and support the circulation, the introduction of parenteral nutritional support, and the development of positive pressure mechanical ventilation and hemodialysis all served to reduce the mortality for wartime trauma from close to 100% at the turn of the century to less than 5% by the time of the Vietnam War.1 Rapid death from acute physiological insufficiency gave way to uncomplicated recovery for some; for others, it opened the door to an entirely new series of problems—the sequelae of life-threatening physiological instability and of the deleterious consequences of the interventions employed to sustain life during a period of otherwise lethal organ system insufficiency. Known as the multiple organ dysfunction syndrome (MODS),2 this panoply of clinical problems has emerged as the leading unsolved problem in the management of the critically ill.

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Authors
  1. John C. Marshall
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Editors and Affiliations

  1. University of California, San Francisco, USA

    Jeffrey A. Norton MD (Professor and Vice-Chairman of Surgery, Chief) (Professor and Vice-Chairman of Surgery, Chief)

  2. Surgical Service, San Francisco VA Medical Center, San Francisco, California, USA

    Jeffrey A. Norton MD (Professor and Vice-Chairman of Surgery, Chief) (Professor and Vice-Chairman of Surgery, Chief)

  3. Division of General Surgery, Duke University Medical Center, Durham, North Carolina, USA

    R. Randal Bollinger MD, PhD (Professor of Surgery, Professor of Immunology, Chief) (Professor of Surgery, Professor of Immunology, Chief)

  4. Division of Surgical Oncology, University of Michigan, Comprehensive Cancer Center, Ann Arbor, Michigan, USA

    Alfred E. Chang MD (Chief, Hugh Cabot Professor of Surgery) (Chief, Hugh Cabot Professor of Surgery)

  5. Department of Surgery, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA

    Stephen F. Lowry MD (Professor and Chairman) (Professor and Chairman)

  6. Division of General Surgery, University of California, San Francisco, San Francisco, California, USA

    Sean J. Mulvihill MD (Professor of Surgery, Chief) (Professor of Surgery, Chief)

  7. Karmanos Cancer Institute, Wayne State University, Harper Hospital, Detroit, Michigan, USA

    Harvey I. Pass MD (Professor of Surgery and Oncology, Chief of Thoracic Oncology) (Professor of Surgery and Oncology, Chief of Thoracic Oncology)

  8. Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri, USA

    Robert W. Thompson MD (Associate Professor of Surgery) (Associate Professor of Surgery)

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Marshall, J.C. (2001). Risk Prediction and Outcome Description in Critical Surgical Illness. In: Norton, J.A., et al. Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57282-1_18

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  • DOI: https://doi.org/10.1007/978-3-642-57282-1_18

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