사망 예측 모델 ( Mortality probability Model 2 ) 을 이용한 중환자 사망분석

Background: The mortality probability model (MPM) II is a system that can predict the mortality of intensive care unit patients and calculate a mortality probability for each patients and each intensive care unit. Thus, it can be used for quality assessment of intensive care units. To determine the validation and usefulness of the MPM II model, we calculated expected mortality probabilities for real intensive care unit patients by using the MPM II model, and we compared the results with the observed mortality. Materials and Methods : One hundred ICU patients (males 69, females 31, average age 59.5±16.2 years old) who were admitted to intensive care units were included for study. Among the 100 patients, 48 patients survived, and 52 patients expired in the hospital. MPM0 (a mortality probability at ICU admission) and MPM24 (a mortality probability at 24 hr after admission) were calculated. Results: Both the MPM0 and the MPM24 have an excellent ability to predict mortality (Hosmer-Lemeshow goodness of fit tests, p=0.4955 (MPM0), p=0.8226 (MPM24) and to discriminate death from survival (area under the ROC curve=0.919 (MPM0), 0.956 (MPM24). The observed mortality was larger than the expected mortality in both the MPM0 and the MPM24. Conclusion: As a result of above, the MPM II model has an excellent power of mortality prediction and discrimination and can be a useful tool for quality assessment of intensive care units.