Deaths in intensive care: analysis and prediction.

Analysis of the data relating to the most critically ill (grade IV) patients admitted to the intensive care unit at Flinders Medical Centre in 1977 and 1978 has been carried out. The mortality rate in this group was 37% in 1977, and 32% in 1978. No absolute predictors of outcome were found, indicating the need for early aggressive investigation and management of critically ill patients. The disease state, and the presence of coma or renal failure, were useful guides to prognosis. Cardiovascular system failure was the cause of death in 51% of patients, and central nervous system failure the cause of death in 28% of patients. Comparison with other published results was difficult because of the lack of standard methods of data reporting. Maintenance of life support was ceased in 28 patients, 15 of whom did not have brain death. Criteria for making such a decision are proposed.