الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Summary
Critical illness causes profound pathophysiological changes in
almost all organ function, particularly the cardiovascular, respiratory,
renal and hepato-billiary systems. Both the neuroendocrine and immune
systems interact with molecular pathways that contribute to
neuropsychiatric and muscular systems changes which leads to functional
impairments resulting in important adverse outcomes among survivors of
critically ill patient.
Assessment and early recognition of critically ill patients in
systematic approach is essential and leads to early treatment and
improvement of prognosis.
Scoring systems used in critically ill patients can be broadly
divided into those that are specific for an organ or disease (for example,
the Glasgow Coma Scale (GCS) and FOUR score in comatosed patient,
Berlin Criteria in ARDS, Child-Pugh classification, MELD score and
KCC for liver diseases, RIFLE and AKIN Criteria for AKI and ISTH
Diagnostic Scoring System for DIC) and those that are general for all
ICU patients. The general scores can broadly be divided into mortality
prediction systems for example: (APACHE I, II, III, and IV), (SAPS I, II
and III), and Mortality Probability Model (MPM I, II and III), morbidity
prediction systems (for example: MODS, SOFA and LODS scores).
It is to be emphasized that scoring systems were developed in
groups of patients and should not replace individualized patient care and
decision making in the ICU.
Garnering maximal value from scoring system data requires indepth
knowledge of how these scoring systems behave in different
populations, and how care changes over time.
Summary
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Scoring systems are widely used in the ICU to predict outcome,
characterize disease severity and degree of organ dysfunction, assess
resource use, evaluate new therapies, compare ICU care across various
settings, and demonstrate equivalence of study and control patients in
clinical research.
Broader adoption of scoring systems in our country should be
strongly encouraged as it is crucial to overall care and improve outcomes
in critically ill patients.