Respiratory failure & ventilation
Subjective and objective survival prediction in mechanically ventilated critically ill patients: a prospective cohort study
Authors' conclusion
Subjective survival estimates are simple, cheap and similarly discriminative as objective models; however, they overestimate death risking that live-saving therapies are withheld.
Study context
- Population
- Mechanically ventilated critically ill patients, five European centres
- Participants
- 961 participants · 5 European centres
- Exposure
- Subjective survival estimates vs objective predictor models
- Outcome
- Discrimination of 28-day survival
- Follow-up
- 28 days
Methodological detailsmulticentre, retrospectively registered October 31st 2013
- Multicentre
- Retrospectively registered October 31st 2013
Main finding
As reported in the abstract
Discrimination of 28-day survival (c-statistic)
Nurses
0.74
c-statistic · 95% CI 0.70–0.78
Junior physicians
0.78
c-statistic · 95% CI 0.74–0.81
Attending physicians
0.75
c-statistic · 95% CI 0.72–0.79
All objective predictors
0.67-0.72
c-statistic
Observational data: associations, not effects.
Further findings
28-day survival
- 28-day survival
- 73.8%
- Single objective predictors of 28-day survival
- 27
Objective predictive group models
- Patient characteristics and treatment models performed poorly; disease and biomarker models moderate for 28-day survival, improved for 1-year survival
Calibration of subjective estimates
- Subjective estimates insufficiently calibrated, overestimating death in high-risk patients in absolute terms
- about 20%
Combined subjective and objective measures
- Refined discrimination and reduced overestimation of death
Original publication
Subjective and objective survival prediction in mechanically ventilated critically ill patients: a prospective cohort study. Crit Care. Published 19 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →