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Thickness Unto Death?

Jeffrey J. Sacks, MD, MPH; Marcia L. Will, MD; Donna F. Stroup, PhD
JAMA. 1987;257(12):1603. doi:10.1001/jama.1987.03390120065024.
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To the Editor.—  Two generic scoring systems are commonly used to quantitatively assess the severity of illness of intensive care unit (ICU) patients. These scoring systems are based on either physiological or therapeutic indexes.1-3 As part of a retrospective study of ICU patients, we assessed their illness severity using both systems. For each of 302 patients (103 with cardiac arrest, 199 with no cardiac arrest), we calculated a patient classification system (PCS) score. This score is used by some hospitals to measure the amount of nursing care required per patient and is a modification of a therapeutic intervention scoring system.1 To validate the PCS score, a stratified random sample of 62 patients (26 with cardiac arrest, 36 with no cardiac arrest) was scored with the APACHE II, a physiologically based illness scoring system that has been shown to be a valid predictor of risk of death in ICU


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