scholarly journals The impact of low-risk intensive care unit admissions on mortality probabilities by SAPS II, APACHE II and APACHE III

Anaesthesia ◽  
2002 ◽  
Vol 57 (1) ◽  
pp. 21-26 ◽  
Author(s):  
D. H. Beck ◽  
G. B. Smith ◽  
B. L. Taylor
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Low Risk ◽  
Apache Ii ◽  
Saps Ii ◽  
Apache Iii ◽  
The Impact

scholarly journals Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and one year mortality prediction in a mixed intensive care unit in Poland: a cohort study

2020 ◽  
Author(s):  
Szymon Czajka ◽  
Katarzyna Ziębińska ◽  
Konstanty Marczenko ◽  
Barbara Posmyk ◽  
Anna Szczepańska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Diagnostic Accuracy ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Post Discharge ◽  
Saps Ii ◽  
Apache Iii

Abstract Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.78; 95%CI 0.73-0.83), APACHE III (AUC=0.79; 95%CI 0.74-0.84) and SAPS II (AUC=0.79; 95%CI 0.74-0.84); as well as mortality after hospital discharge (p<0.05): APACHE II (AUC=0.71; 95%CI 0.64-0.78), APACHE III (AUC=0.72; 95%CI 0.65-0.78) and SAPS II (AUC=0.69; 95%CI 0.62-0.76), with no statistically significant difference between the scores (p>0.05). The calibration of the scores was good. Conclusions. All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

scholarly journals Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and one year mortality prediction in a mixed intensive care unit in Poland: a cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Szymon Czajka ◽  
Katarzyna Ziębińska ◽  
Konstanty Marczenko ◽  
Barbara Posmyk ◽  
Anna J. Szczepańska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Diagnostic Accuracy ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Post Discharge ◽  
Saps Ii ◽  
Apache Iii

Abstract Background There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12–24), 67 (36.5–88) and 44 (27–56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1–46.0), 18.5% (IQR 3.8–41.8) and 34.8% (IQR 7.9–59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p < 0.05): APACHE II (AUC = 0.78; 95%CI 0.73–0.83), APACHE III (AUC = 0.79; 95%CI 0.74–0.84) and SAPS II (AUC = 0.79; 95%CI 0.74–0.84); as well as mortality after hospital discharge (p < 0.05): APACHE II (AUC = 0.71; 95%CI 0.64–0.78), APACHE III (AUC = 0.72; 95%CI 0.65–0.78) and SAPS II (AUC = 0.69; 95%CI 0.62–0.76), with no statistically significant difference between the scores (p > 0.05). The calibration of the scores was good. Conclusions All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

Evaluation of single intensive care unit performance in Croatia using APACHE II and SAPS II systems

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 169
Author(s):  
K. Desa ◽  
Z. Zupan ◽  
B. Krstulovic ◽  
V. Golubovic ◽  
A. Sustic
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Apache Ii ◽  
Saps Ii ◽  
Unit Performance

scholarly journals Relationships between APACHE II and APACHE III Scores and Mortality Rate in Intensive Care Unit Patients

1999 ◽  
Vol 37 (5) ◽  
pp. 814
Author(s):  
Shin Ok Koh ◽  
Ki Jun Kim ◽  
Eun Chi Bang ◽  
Sung Won Na ◽  
Yong Taek Nam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Apache Ii ◽  
Apache Iii

scholarly journals Outcome of Patients With Necrotizing Vasculitis Admitted to the Intensive Care Unit (ICU) for Sepsis: Results of a Single-Centre Retrospective Analysis

2020 ◽  
pp. 088506662095376
Author(s):  
Marco Krasselt ◽  
Christoph Baerwald ◽  
Sirak Petros ◽  
Olga Seifert
Keyword(s):  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Tertiary Hospital ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Necrotizing Vasculitis ◽  
Multivariate Logistic Regression ◽  
Sepsis Mortality ◽  
Saps Ii

Introduction/Background: Vasculitis patients have a high risk for infections that may require intensive care unit (ICU) treatment in case of resulting sepsis. Since data on sepsis mortality in this patient group is limited, the present study investigated the clinical characteristics and outcomes of vasculitis patients admitted to the ICU for sepsis. Methods: The medical records of all necrotizing vasculitis patients admitted to the ICU of a tertiary hospital for sepsis in a 13-year period have been reviewed. Mortality was calculated and multivariate logistic regression was used to determine independent risk factors for sepsis mortality. Moreover, the predictive power of common ICU scores was further evaluated. Results: The study included 34 patients with necrotizing vasculitis (mean age 69 ± 9.9 years, 35.3% females). 47.1% (n = 16) were treated with immunosuppressives (mostly cyclophosphamide, n = 35.3%) and 76.5% (n = 26) received glucocorticoids. Rituximab was used in 4 patients (11.8%).The in-hospital mortality of septic vasculitis patients was 41.2%. The Sequential Organ Failure Assessment (SOFA) score (p = 0.003) was independently associated with mortality in multivariate logistic regression. Acute Physiology And Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II) and SOFA scores were good predictors of sepsis mortality in the investigated vasculitis patients (APACHE II AUC 0.73, p = 0.02; SAPS II AUC 0.81, p < 0.01; SOFA AUC 0.898, p < 0.0001). Conclusions: Sepsis mortality was high in vasculitis patients. SOFA was independently associated with mortality in a logistic regression model. SOFA and other well-established ICU scores were good mortality predictors.

scholarly journals Performance of Prognostic Scoring Systems in Trauma Patients in the Intensive Care Unit of a Trauma Center

2020 ◽  
Vol 17 (19) ◽  
pp. 7226
Author(s):  
Shao-Chun Wu ◽  
Sheng-En Chou ◽  
Hang-Tsung Liu ◽  
Ting-Min Hsieh ◽  
Wei-Ti Su ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Scoring Systems ◽  
Predictive Performance ◽  
Apache Ii ◽  
Trauma Patients ◽  
Saps Ii ◽  
Significant Difference ◽  
Prognostic Scoring Systems

Background: Prediction of mortality outcomes in trauma patients in the intensive care unit (ICU) is important for patient care and quality improvement. We aimed to measure the performance of 11 prognostic scoring systems for predicting mortality outcomes in trauma patients in the ICU. Methods: Prospectively registered data in the Trauma Registry System from 1 January 2016 to 31 December 2018 were used to extract scores from prognostic scoring systems for 1554 trauma patients in the ICU. The following systems were used: the Trauma and Injury Severity Score (TRISS); the Acute Physiology and Chronic Health Evaluation (APACHE II); the Simplified Acute Physiology Score (SAPS II); mortality prediction models (MPM II) at admission, 24, 48, and 72 h; the Multiple Organ Dysfunction Score (MODS); the Sequential Organ Failure Assessment (SOFA); the Logistic Organ Dysfunction Score (LODS); and the Three Days Recalibrated ICU Outcome Score (TRIOS). Predictive performance was determined according to the area under the receiver operator characteristic curve (AUC). Results: MPM II at 24 h had the highest AUC (0.9213), followed by MPM II at 48 h (AUC: 0.9105). MPM II at 24, 48, and 72 h (0.8956) had a significantly higher AUC than the TRISS (AUC: 0.8814), APACHE II (AUC: 0.8923), SAPS II (AUC: 0.9044), MPM II at admission (AUC: 0.9063), MODS (AUC: 0.8179), SOFA (AUC: 0.7073), LODS (AUC: 0.9013), and TRIOS (AUC: 0.8701). There was no significant difference in the predictive performance of MPM II at 24 and 48 h (p = 0.37) or at 72 h (p = 0.10). Conclusions: We compared 11 prognostic scoring systems and demonstrated that MPM II at 24 h had the best predictive performance for 1554 trauma patients in the ICU.

scholarly journals Combination of APACHE Scoring Systems with Adductor Pollicis Muscle Thickness for the Prediction of Mortality in Patients Who Spend More Than One Day in the Intensive Care Unit

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Elahe Nematifard ◽  
Seyed Hossein Ardehali ◽  
Shaahin Shahbazi ◽  
Hassan Eini-Zinab ◽  
Zahra Vahdat Shariatpanahi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring Systems ◽  
Roc Curves ◽  
Adductor Pollicis ◽  
Interquartile Range ◽  
Apache Ii ◽  
Adductor Pollicis Muscle ◽  
Prediction Of Mortality ◽  
Apache Iii

Background. The objective of the present study was to compare the ability of Acute Physiology and Chronic Health Evaluation (APACHE) scoring systems with the combination of an anthropometric variable score “adductor pollicis muscle (APM) thickness” to the APACHE systems in predicting mortality in the intensive care unit. Methods. A prospective observational study was conducted with the APM thickness in the dominant hand, and APACHE II and III scores were measured for each patient upon admission. Given scores for the APM thickness were added to APACHE score systems to make two composite scores of APACHE II-APM and APACHE III-APM. The accuracy of the two composite models and APACHE II and III systems in predicting mortality of patients was compared using the area under the ROC curve. Results. Three hundred and four patients with the mean age of 54.75 ± 18.28 years were studied, of which 96 (31.57%) patients died. Median (interquartile range) of APACHE II and III scores was 15 (12–20) and 47 (33–66), respectively. Median (interquartile range) of APM thickness was 15 (12–17) mm, respectively. The area under the ROC curves for the prediction of mortality was 0.771 (95% CI: 0.715–0.827), 0.802 (95% CI: 0.751–0.854), 0.851 (95% CI: 0.807–0.896), and 0.865 (95% CI: 0.822–0.908) for APACHE II, APACHE III, APACHE II-APM, and APACHE III-APM, respectively. Conclusion. Although improvements in the area under ROC curves were not statistically significant when the APM thickness added to the APACHE systems, but the numerical value added to AUCs are considerable.

scholarly journals Why the surgical patients are so critical in their intensive care unit arrival?

2013 ◽  
Vol 28 (suppl 1) ◽  
pp. 48-53 ◽  
Author(s):  
Anibal Basile-Filho ◽  
Mayra Gonçalves Menegueti ◽  
Maria Auxiliadora-Martins ◽  
Edson Antonio Nicolini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Negative Impact ◽  
Survival Rates ◽  
Severity Of Illness ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Death Risk ◽  
Icu Transfer ◽  
The Impact

PURPOSE: To assess the ability of the Acute Physiology and Chronic Health Evaluation II (APACHE II) to stratify the severity of illness and the impact of delay transfer to an Intensive Care Unit (ICU) on the mortality of surgical critically ill patients. METHODS: Five hundred and twenty-nine patients (60.3% males and 39.7% females; mean age of 52.8 ± 18.5 years) admitted to the ICU were retrospectively studied. The patients were divided into survivors (n=365) and nonsurvivors (n=164). APACHE II and death risk were analysed by generation of receiver operating characteristic (ROC) curves. The interval time between referral and ICU arrival was also registered. The level of significance was 0.05. RESULTS: The mean APACHE II and death risk was 19.9 ± 9.6 and 37.7 ± 28.9%, respectively. The area under the ROC curve for APACHE II and death risk was 0.825 (CI = 0.765-0.875) and 0.803 (CI = 0.741-0.856). The overall mortality (31%) increased progressively with the delay time to ICU transfer, as also evidencied by the APACHE II score and death risk. CONCLUSION: This investigation shows that the longer patients wait for ICU transfer the higher is their criticallity upon ICU arrival, with an obvious negative impact on survival rates.

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