Recalibration of Acute Physiology and Chronic Health Evaluation II (APACHE II) for mortality prediction in an adult intensive care population to include novel COVID pneumonia diagnostic category

2022 ◽  
Vol 128 (2) ◽  
pp. e60-e61
Author(s):  
R.A.S. Campbell ◽  
M. Shaw ◽  
R. Hart ◽  
T. Quasim ◽  
M. Sim ◽  
...  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Bambang Suryadi ◽  
Nurul Ainul Shifa

Pendahuluan: dalam penentuan kebutuhan dan prognosis kematian pasien diperlukan skoring kematian di Intensive care unit (ICU). Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan skoring Acute Physiology And Chronic Health Evaluation (APACHE II) terhadap angka kematian pada pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor Tahun 2019. Metode: rancangan dalam penelitian ini adalah cross sectional. Jumlah sampel yaitu 56 pasien gagal nafas. Intrumen menggunakan lembar cheklist apache dan uji statistik menggunakan uji Chi Square. Hasil:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor dengan Pvalue 0,02 dan OR 4,63. Kesimpulan:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas. Diharapkan perawat membuat integrasi ICU dengan perhitungan APACHE II di ruang ICU.


2012 ◽  
Vol 78 (11) ◽  
pp. 1261-1269
Author(s):  
Robert D. Becher ◽  
Michael C. Chang ◽  
J. Jason Hoth ◽  
Jennifer L. Kendall ◽  
H. Randall Beard ◽  
...  

The Acute Physiology and Chronic Health Evaluation II (APACHE II) score has never been validated to risk-adjust between critically ill trauma (TICU) and general surgical (SICU) intensive care unit patients, yet it is commonly used for such a purpose. To study this, we evaluated risk of death in TICU and SICU patients with pneumonia. We hypothesized that mortality for a given APACHE II would be significantly different and that using APACHE II to directly compare TICU and SICU patients would not be appropriate. We conducted a retrospective review of patients admitted to the TICU or SICU at a tertiary medical center over an 18-month period with pneumonia. Admission APACHE II scores, in-hospital mortality, demographics, and illness characteristics were recorded. One hundred eighty patients met inclusion criteria, 116 in the TICU and 64 in the SICU. Average APACHE II scores were not significantly different in the TICU versus SICU (25 vs 24; P = 0.4607), indicating similar disease severity; overall mortality rates, however, were significantly different (24 vs 50%; P = 0.0004). Components of APACHE II, which contributed to this mortality differential, were Glasgow Coma Score, age, presence of chronic health problems, and operative intervention. APACHE II fails to provide a valid metric to directly compare the severity of disease between TICU and SICU patients with pneumonia. These groups represent distinct populations and should be separated when benchmarking outcomes or creating performance metrics in ICU patients. Improved severity scoring systems are needed to conduct clinically relevant and methodologically valid comparisons between these unique groups.


2018 ◽  
Vol 12 (8) ◽  
pp. 2074
Author(s):  
Keemberly Trindade Valcacio ◽  
Tayse Tâmara Paixão Duarte ◽  
Marcia Cristina Silva Magro

RESUMOObjetivo: identificar se há relação entre obesidade e a ocorrência de lesão renal aguda (LRA) em pacientes no pós-operatório de revascularização do miocárdio. Método: estudo quantitativo, longitudinal e prospectivo realizado na unidade de terapia intensiva (UTI) cirúrgica geral de um hospital terciário privado, com 57 pacientes. Adotou-se um questionário estruturado para a coleta de dados. Realizou-se análise descritiva e inferencial dos dados. Resultados com p < 0,05 foram considerados significativos. Resultados: a maioria dos pacientes era idosa (63±9 anos). Mais da metade dos pacientes obesos evoluíram de forma significativa com lesão ou falência renal (p = 0,01). O tempo cirúrgico em pacientes obesos foi superior (p = 0,01). O índice de gravidade Acute Physiology and Chronic Health Evaluation (APACHE II) foi maior nos pacientes com sobrepeso quando comparado aos obesos (p = 0,01). Conclusão: houve relação entre obesidade e a ocorrência de LRA. Assim, o aumento da compreensão dessa relação pode orientar profissionais da saúde, inclusive enfermeiros, na elaboração de medidas de prevenção e, consequentemente, melhorar a qualidade de vida da população, além de diminuir os custos ao sistema de saúde. Descritores: Obesidade; Lesão Renal Aguda; Cirurgia Torácica; Índice de Massa Corporal; Unidades de Terapia Intensiva; Prevenção de Doenças.ABSTRACTObjective: identify whether there is a relation between obesity and the occurrence of acute kidney injury (AKI) in patients within the post-operative period of myocardial revascularization. Method: quantitative, longitudinal, and prospective study conducted at the general surgical intensive care unit (ICU) in a private tertiary hospital with 57 patients. We adopted a structured questionnaire for data collection. A descriptive and inferential data analysis was performed. Results with p < 0.05 were considered significant. Results: most of the patients were elderly (63±9 years). More than half of the obese patients evolved significantly with kidney injury or renal failure (p = 0.01). The surgery time in obese patients was higher (p = 0.01). The severity index Acute Physiology and Chronic Health Evaluation (APACHE II) was higher in overweight patients when compared to obese patients (p = 0.01). Conclusion: there was a relation between obesity and the occurrence of AKI. Thus, an increased understanding of this relation may guide health professionals, including nurses, in the preparation of preventive measures and, consequently, improve the population’s quality of life, besides reducing costs to the health system. Descriptors: Obesity; Acute Kidney Injury; Thoracic Surgery; Body Mass Index; Intensive Care Units; Disease Prevention.RESUMENObjetivo: identificar si existe una relación entre obesidad y la aparición de lesión renal aguda (LRA) en pacientes en el postoperatorio de revascularización del miocardio. Método: estudio cuantitativo, longitudinal y prospectivo realizado en la unidad de cuidados intensivos (UCI) quirúrgicos general de un hospital terciario privado con 57 pacientes. Se adoptó un cuestionario estructuradoatorio para la recogida de datos. Se realizó un análisis descriptivo e inferencial de los datos. Resultados con p < 0,05 se consideraron significativos. Resultados: la mayoría de los pacientes eran ancianos (63±9 años). Más de la mitad de los pacientes obesos evolucionaron significativamente con lesión o insuficiencia renal (p = 0,01). El tiempo quirúrgico en pacientes obesos fue mayor (p = 0,01). El índice de gravedad Acute Physiology and Chronic Health Evaluation (APACHE II) fue mayor en pacientes con sobrepeso en comparación con obesos (p = 0,01). Conclusión: hubo una relación entre obesidad y la aparición de LRA. Así, una mayor comprensión de esta relación puede orientar a los profesionales de la salud, incluyendo enfermeros, en la preparación de medidas preventivas y, en consecuencia, mejorar la calidad de vida de la población, además de reducir los costos para el sistema de salud. Descriptores: Obesidad; Lesión Renal Aguda; Cirugía Torácica; Índice de Masa Corporal; Unidades de Cuidados Intensivos; Prevención de Enfermedades.


1991 ◽  
Vol 19 (8) ◽  
pp. 1048-1053 ◽  
Author(s):  
ROBERT RUTLEDGE ◽  
SAMIR M. FAKHRY ◽  
EDMUND J. RUTHERFORD ◽  
FARID MUAKKASSA ◽  
CHRISTOPHER C. BAKER ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document