Facial appearance, whether consciously or subconsciously assessed, may affect clinical assessment and treatment strategies in the Intensive Care Unit (ICU). Nevertheless, the association between objective clinical measurement of facial appearance and multi-organ failure is currently unknown. The objective of this study was to examine whether facial appearance at admission is associated with longitudinal evaluation of multi-organ failure. This was a sub-study of the Simple Intensive Care Studies-II, a prospective observational cohort study. All adult patients acutely admitted to the ICU between March 26, 2019, and July 10, 2019, were included. Facial appearance was assessed within three hours of ICU admission using predefined pictograms. The SOFA score was serially measured each day for the first seven days after ICU admission. The association between the extent of eye-opening and facial skin colour with longitudinal Sequential Organ Failure Assessment (SOFA) scores was investigated using generalized estimation equations. SOFA scores were measured in 228 patients. Facial appearance scored by the extent of eye-opening was associated with a higher SOFA score at admission and follow-up (unadjusted 0.7 points per step (95%CI 0.5 to 0.9)). There was no association between facial skin colour and a worse SOFA score over time. However, patients with half-open or closed eyes along with flushed skin had a lower SOFA score than patients with a pale or normal facial skin colour (P-interaction < 0.1). The scoring of patients’ facial cues, primarily the extent of eye-opening and facial colour, provided valuable insights into the disease state and progression of the disease of critically ill patients. The utilization of advanced monitoring techniques that incorporate facial appearance holds promise for enhancing future intensive care support.

中文翻译：

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面部外观与纵向多器官衰竭相关：一项 ICU 队列研究

面部外观，无论是有意识还是无意识地评估，都可能影响重症监护病房 (ICU) 的临床评估和治疗策略。然而，面部外观的客观临床测量与多器官衰竭之间的关联目前尚不清楚。本研究的目的是检查入院时的面部外观是否与多器官衰竭的纵向评估相关。这是简单重症监护研究 II（一项前瞻性观察队列研究）的子研究。包括2019年3月26日至2019年7月10日期间急性入住ICU的所有成年患者。使用预定义的象形图在进入 ICU 后的三个小时内评估面部外观。入住 ICU 后的前 7 天每天连续测量 SOFA 评分。使用广义估计方程研究了睁眼程度和面部肤色与纵向序贯器官衰竭评估（SOFA）评分之间的关​​联。对 228 名患者进行了 SOFA 评分测量。根据睁眼程度评分的面部外观与入院和随访时较高的 SOFA 评分相关（未调整每步 0.7 分（95% CI 0.5 至 0.9））。随着时间的推移，面部肤色与较差的 SOFA 评分之间没有关联。然而，半睁或闭眼且皮肤潮红的患者的 SOFA 评分低于面部肤色苍白或正常的患者（P 交互作用 < 0.1）。对患者面部线索的评分，主要是睁眼程度和面部颜色，为了解危重患者的疾病状态和疾病进展提供了有价值的见解。利用结合面部外观的先进监测技术有望增强未来的重症监护支持。