[Scoring systems for daily assessment in intensive care medicine. Overview, current possibilities and demands on new developments]

Abstract

Scoring systems are a fixed element of modern diagnostics and are integrated in the diagnosis-related groups (DRG) billing system as well as quality assurance projects. The ongoing developments require classification according to the terms of use in order to maintain an overview of the numerous systems available. In the area of intensive care medicine scoring systems can be divided into admission scores and progress scores, whereby the scores for daily assessment can be further subdivided into five categories, depending on the target criteria: objective description of the grade of organ dysfunction, progression in intensive care therapy, evaluation of the degree of nursing care, determination of outcome/mortality risk, and grouping of patient collectives for clinical trials. In future developments it will be necessary to generate new strategies to adequately describe the progress of a patient. Not only will mortality be challenged as a target criterion but also the handling of missing data and the simplification of reality by categorization practised so far that can be found in all established scoring systems as far as calculation of predictive values regarding a defined result.