Prognostication and intensive care unit outcome: the evolving role of scoring systems

Scoring systems for critically ill patients should be viewed as works in progress. Their evolution is driven by new insights into the pathophysiology of critical illness and the adoption of a new philosophy of critical illness as a continuum from inciting disease to ICU management to post-ICU rehabilitation. Newer applications for existing scoring systems have enabled us to better characterize the burden of organ failure throughout the ICU stay, to more fully understand what is truly ICU-acquired morbidity, and how the severity of critical illness has important implications for long-term outcome.