APACHE II SCORE AND OUTCOME IN THE SURGICAL INTENSIVE CARE UNIT (SICU)

1990 ◽  
Vol 18 (Supplement) ◽  
pp. S271
Author(s):  
Robert Rutledge ◽  
Edmund Rutherford ◽  
Samir Fakhry ◽  
Farid Muakkassa ◽  
Christopher Baker ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Surgical Intensive Care

Obesity Does Not Affect Mortality after Trauma

2006 ◽  
Vol 72 (10) ◽  
pp. 966-969 ◽  
Author(s):  
Rodrigo F. Alban ◽  
Sergey Lyass ◽  
Daniel R. Margulies ◽  
M. Michael Shabot
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Adverse Outcomes ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Surgical Intensive Care ◽  
Significant Difference ◽  
Nonobese Patients

Although obesity has been proposed as a risk factor for adverse outcomes after trauma, numerous studies report conflicting results. The objective of this study was to compare outcomes of obese and nonobese patients after trauma. The study population consisted of all trauma patients admitted to a surgical intensive care unit in a Level I trauma center from January 1999 to December 2002. Admission data, demographics, injury severity score (ISS), severity of illness, hospital course, complications, and outcomes were compared between obese (OB; body mass index [BMI] ≥ 30), and nonobese patients (NOB; BMI ≤ 29). A total of 918 patients was included in the study, 135 OB (14.7%) and 783 NOB (85.3%). There was no significant difference in demographic data, ISS, APACHE II score, and hospital stay. Intensive care unit stay was longer for OB patients (6.8 vs 4.8 days, P = 0.04). Overall mortality was 5.9 per cent for OB and 8.0 per cent for NOB patients (P = 0.48). Mortality by mechanism of injury was 3.4 per cent OB versus 7.4 per cent NOB (P = 0.26) for blunt and 10.6 per cent OB versus 10.2 per cent NOB (P = 0.9) for penetrating injury. The three most common complications associated with death were pulmonary, cardiovascular, and neurological deterioration. Using logistic regression analysis, age and ISS and APACHE II scores were associated with mortality, but BMI was not. We conclude that obesity does not appear to be a risk factor for adverse outcomes after blunt or penetrating trauma. Further research is warranted to uncover the reason for discrepant findings between centers.

Acute Physiology and Chronic Health Evaluation (APACHE II) score and outcome in the surgical intensive care unit

1991 ◽  
Vol 19 (8) ◽  
pp. 1048-1053 ◽  
Author(s):  
ROBERT RUTLEDGE ◽  
SAMIR M. FAKHRY ◽  
EDMUND J. RUTHERFORD ◽  
FARID MUAKKASSA ◽  
CHRISTOPHER C. BAKER ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Surgical Intensive Care ◽  
Chronic Health

scholarly journals Data Science for Extubation Prediction and Value of Information in Surgical Intensive Care Unit

2019 ◽  
Vol 8 (10) ◽  
pp. 1709 ◽  
Author(s):  
Tsung-Lun Tsai ◽  
Min-Hsin Huang ◽  
Chia-Yen Lee ◽  
Wu-Wei Lai
Keyword(s):  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Prediction Model ◽  
Value Of Information ◽  
Data Science ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Science Framework

Besides the traditional indices such as biochemistry, arterial blood gas, rapid shallow breathing index (RSBI), acute physiology and chronic health evaluation (APACHE) II score, this study suggests a data science framework for extubation prediction in the surgical intensive care unit (SICU) and investigates the value of the information our prediction model provides. A data science framework including variable selection (e.g., multivariate adaptive regression splines, stepwise logistic regression and random forest), prediction models (e.g., support vector machine, boosting logistic regression and backpropagation neural network (BPN)) and decision analysis (e.g., Bayesian method) is proposed to identify the important variables and support the extubation decision. An empirical study of a leading hospital in Taiwan in 2015–2016 is conducted to validate the proposed framework. The results show that APACHE II and white blood cells (WBC) are the two most critical variables, and then the priority sequence is eye opening, heart rate, glucose, sodium and hematocrit. BPN with selected variables shows better prediction performance (sensitivity: 0.830; specificity: 0.890; accuracy 0.860) than that with APACHE II or RSBI. The value of information is further investigated and shows that the expected value of experimentation (EVE), 0.652 days (patient staying in the ICU), is saved when comparing with current clinical experience. Furthermore, the maximal value of information occurs in a failure rate around 7.1% and it reveals the “best applicable condition” of the proposed prediction model. The results validate the decision quality and useful information provided by our predicted model.

Does Acute Physiology and Chronic Health Evaluation II Provide a Valid Metric to Directly Compare Disease Severity in Trauma versus Surgical Intensive Care Unit Patients?

2012 ◽  
Vol 78 (11) ◽  
pp. 1261-1269
Author(s):  
Robert D. Becher ◽  
Michael C. Chang ◽  
J. Jason Hoth ◽  
Jennifer L. Kendall ◽  
H. Randall Beard ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Severity ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Chronic Health ◽  
Risk Of Death

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.

Interrater Reliability of APACHE II Scores for Medical-Surgical Intensive Care Patients: A Prospective Blinded Study

2007 ◽  
Vol 16 (4) ◽  
pp. 378-383 ◽  
Author(s):  
Michelle E. Kho ◽  
Ellen McDonald ◽  
Paul W. Stratford ◽  
Deborah J. Cook
Keyword(s):  
Intensive Care ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Illness Severity ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Surgical Intensive Care ◽  
Chronic Health ◽  
Severity Scores

Background Despite widespread use of the Acute Physiology and Chronic Health Evaluation II (APACHE II), its interrater reliability has not been well studied. Objective To determine interrater reliability of APACHE II scores among 1 intensive care nurse and 2 research clerks. Methods In a prospective, blinded, observational study, 3 raters collected APACHE II scores on 37 consecutive patients in a medical-surgical intensive care unit. One research clerk was blinded to the study’s start date to minimize observer bias. The nurse and the other research clerk were blinded to each other’s scores and did not communicate with the first research clerk about the study. The data analyst was blinded to the identity and source of all 3 raters’ scores. Intraclass correlation coefficients and 95% confidence intervals were assessed. Results Mean (standard deviation) APACHE II scores were 21.8 (9.2) for the nurse, 20.4 (7.7) for research clerk 1, and 20.5 (8.1) for research clerk 2. Among the 3 raters, the intraclass correlation coefficient (95% confidence interval) was 0.90 (0.84, 0.94) for the APACHE II total score. Within APACHE II score components, the highest reliability was for age (0.98 [0.97, 0.99]), with lower reliabilities for the Chronic Health Index (0.64 [0.50, 0.80]) and the verbal component of the Glasgow Coma Scale (0.40 [0.20, 0.60]). Results were similar between pairs of raters. Conclusions Use of trained nonmedical personnel to collect illness severity scores for clinical, research, and administrative purposes is reasonable. This method could be used to assess reliability of other illness severity scores.

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