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2 results

  • 11.4 - Scoring Systems for Severity of Illness in Critical Care

  • from Section 11 - Professionalism, Patient Safety, Governance and Health Systems Management
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 749-751

  • Summary

    Key Learning Points

    1. 1. Predictive scoring systems can use physiological, clinical and laboratory data to predict critical care patient mortality.

    2. 2. Their use extends to enabling standardisation of research cohorts, comparing and auditing critical care units and triaging critical care provision.

    3. 3. The most commonly used general scoring systems worldwide are APACHE (Acute Physiology and Chronic Health Evaluation) II and SOFA (Sequential Organ Failure Assessment) scores.

    4. 4. All systems need to be validated for calibration and discrimination, and have the potential to become less accurate over time.

    5. 5. No one system is better than any other – all have advantages and disadvantages.

  • Negative symptom subgroups have different effects on the clinical course of schizophrenia after the first episode: A 24-month follow up study

  • C. Ergül, A. Üçok
  • Journal:
    European Psychiatry / Volume 30 / Issue 1 / January 2015
    Published online by Cambridge University Press:
    15 April 2020, pp. 14-19
  • Objective:

    The aim of this study was to assess the factor structure of negative symptoms in first-episode schizophrenia (FES), and to examine the relationship of these factors with clinical course and functioning of patients during the two-year follow up.

    Method:

    We assessed 174 drug-naïve patients with FES using Brief Psychiatric Rating Scale-Expanded (BPRS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), and Global Assessment of Functioning (GAF) and a cognitive battery at admission. The scales were repeated monthly during follow up. We recorded the patients’ functioning levels, remission, and work status after 12 and 24 months.

    Results:

    A two-factor structure was found at the baseline, whereas one factor was found after 12 and 24 months. Expressive deficit (ED) factor consisted of alogia and blunted affect, and motivation-pleasure deficit (MPD) factor consisted of avolition and anhedonia. ED factor was related to earlier onset and remission, and it was negatively correlated with duration of education and cognitive test scores. MPD factor was related to duration of untreated psychosis, family history of schizophrenia, and work status, and it appeared as the only independent variable that contributed to the baseline GAF score in linear regression analysis.

    Conclusion:

    Our findings suggest that the factors have different aetiologies and impacts on the clinical course of schizophrenia and functioning after FES.