Patients in the intensive care unit are highly heterogeneous, and include elderly patients who generally have a long history of disease. Prediction of prognosis can often be difficult because of the severity of patient illness and disease history. Severity scores that are based on acute physiology measures are often used in the ICU to predict mortality. However, these scores are non-specific, and individual mortality predictions can often turn out to be inaccurate.

Long-term disease is generally not exploited in clinical settings and is usually not considered when making important clinical decisions. This is ironic, keeping in mind the fact that a large number of ICU patients have long disease histories. The biggest advantage of using long-term disease history is that its predictive value remains stable over time compared with physiology measures. Disease history is also independent of ICU care and can be made available at the time of patient admission to the ICU.

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