Organ Dysfunction Scores in the Adult ICU

Standardized assessments of organ dysfunction in critically ill patients have multiple uses and implications in current clinical and research practice, including prognostication, describing trajectory of illness, screening patients at risk, and as outcomes in current research. Since the development of the scoring systems currently in use, several aspects of clinical practice have evolved, raising the question as to whether existing scores need updating. Multiple criteria (e.g., simplicity, availability, reliability, specificity) should be met when selecting variables for organ dysfunction scores, but ideal variables are difficult to find. Therefore, after careful analysis of large cohorts, a broad consensus including some compromise is likely to be required if updates are to be undertaken. Application of existing organ dysfunction scores as dynamic tools to assist in guiding treatment decisions rather than as tools for prognostication requires further attention and study.