PREDICTION SCORES AND COMPLEXITY OF PHYSICAL THERAPY APPROACH IN THE INTENSIVE CARE UNIT OF THE CLINICAL EMERGENCY HOSPITAL BUCHAREST

Popescu G. ¹, Macovei R.Al. ¹, Ilie Mădălina ¹, Constantinescu G. ², Stănciulescu Elena-Luminița ¹, Pătru Cristina ², Păun M.Al. ¹, Grințescu Ioana Cristina ², Grințescu Ioana Marina ^1
1 University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
² Clinical Emergency Hospital Bucharest, Romania

Abstract

Evaluation scores of critically ill patients began to develop in the ‘70s, in an attempt to create a real model to allow the quantification of disease severity, outcomes, prognosis and mortality rate of hospitalized patients in ICU. Over time many such scores were developed, some of them have lost practical value, being no longer in use, others are important tools in assessing critically ill patients. There are basically four areas of application of these scores: research and clinical trials – for this purpose, scores serve as common, standardized tools of patient comparison, as a common language for researchers and clinicians, who may thus decide how the results of clinical research can influence their daily practice; administrative field – refers to the capital allocation depending on the disease severity, to cost-effectiveness analysis; performance assessment field: comparative performance assessment of ICU from year to year is important, as well as, individual performance assessment; assessment of individual prognosis and treatment protocols or decisions. There are four known validated prediction scores: APACHE (Acute Physiology and Chronic Health Evaluation), SAPS (Simplified Acute Physiology Score), MPM (Mortality Prediction Model) and SOFA (Sequential Organ Failure Assessment) score. A prediction score (severity score) represents a numerical value, composed of a variety of clinical parameters, quantifying the severity of the disease. This can be introduced into a mathematical equation, the result reflecting the probability of clinical course, usually the mortality rate. There is an obvious correlation between the severity of the prediction score, length of ICU stay and the complexity of physical therapy. This study aims to demonstrate the importance of starting prompt physical therapy in critically ill patients with high severity scores, significantly influencing individual recovery and prognosis.