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Variables Affecting Outcome in Critically Ill Patients^*

^* From the Johns Hopkins University School of Medicine, Baltimore, MD.

Correspondence to: Bart Chernow, MD, FCCP, Johns Hopkins University School of Medicine, 720 Rutland Ave, Suite 124, Baltimore, MD 21205-2196; e-mail: bchernow{at}jhmi.edu

Critical care medicine has evolved as a field of science and clinical care. Despite important contributions to our understanding of the molecular basis of critical illness, we still remain troubled by our lack of insight into why some patients have favorable outcomes from critical illness and others do not. This article explores the hypothesis that at least five important variables may alter the outcome of patients suffering from a variety of critical illnesses. These variables include the premorbid immune or genetic status of the patient, the patient’s gender, the circulating cholesterol concentration, the patient’s age, and various iatrogenic and nosocomial events. Insights into the importance of these five variables may provide opportunities for physicians and scientists to improve outcome in patients suffering from critical illness. Clearly, altering iatrogenic and nosocomial events is already within the realm of opportunity.

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