Acute Physiology and Chronic Health Evaluation (APACHE) IV: Hospital mortality assessment for today’s critically ill patients*

2006 ◽  
Vol 34 (5) ◽  
pp. 1297-1310 ◽  
Author(s):  
Jack E. Zimmerman ◽  
Andrew A. Kramer ◽  
Douglas S. McNair ◽  
Fern M. Malila
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Chronic Health Evaluation ◽  
Health Evaluation ◽  
Chronic Health ◽  
Apache Iv

scholarly journals A Study on the Effects of Hypomagnesaemia among Critically Ill Patients at a Tertiary Care Hospital of Southern Bihar

2020 ◽  
Vol 7 (43) ◽  
pp. 2458-2462
Author(s):  
Harjot Singh ◽  
Amit Kumar Ranjan ◽  
Ranjan Kumar
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Serum Magnesium ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Electrolyte Imbalance ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Ventilator Support ◽  
Chronic Health

BACKGROUND Hypomagnesaemia is associated with other electrolyte abnormalities like hypokalaemia, hyponatremia, and hypophosphatemia. We wanted to study the serum magnesium levels in critically ill patients, and correlate the serum magnesium levels with patient outcome and other parameters like duration of stay in ICU, ventilator support and APACHE-II (Acute Physiology and Chronic Health Evaluation-II) score. METHODS The study included all the cases admitted in the ICU of Narayan Medical College & Hospital, with variable medical conditions within 6 months fulfilling the inclusion criteria. Demographic data (age and sex), medical history, surgical history, medications administrated and length of ICU stay were recorded for each patient. The severity scoring system used was Acute Physiology and Chronic Health Evaluation-II (APACHE-II). RESULTS Prevalence of Hypomagnesaemia in the present study was 60.2 %. Mortality and mechanical ventilator support (2.7 % and 28.4 %) in normomagnesemia subjects were significantly lesser than hypomagnesaemia subjects (33.9 % and 54.5 % respectively). CONCLUSIONS Hypomagnesaemia is a common electrolyte imbalance in critically ill patients. It is associated with higher mortality and morbidity in critically ill patients and is also associated with more frequent and more prolonged ventilatory support. KEYWORDS Critically Ill, Hypomagnesaemia, APACHE-II Score, Mortality, Ventilator Support

Do Serially Recorded Prognostic Scores Predict Outcome Better Than One-Time Recorded Score on Admission? A Prospective Study in Adult Intensive Care Patients

2016 ◽  
Vol 32 (8) ◽  
pp. 480-486 ◽  
Author(s):  
Sangeeta Manerikar ◽  
Seetharaman Hariharan
Keyword(s):  
Intensive Care ◽  
Hospital Mortality ◽  
Mortality Prediction ◽  
Chronic Health Evaluation ◽  
Health Evaluation ◽  
Chronic Health ◽  
Mortality Prediction Model ◽  
The Mean ◽  
Apache Iv ◽  
Better Than

Objectives: The prognosticating ability of one-time recorded Acute Physiology and Chronic Health Evaluation (APACHE) IV score was compared with serially recorded Mortality Prediction Model (MPM) II scores. Design and Methods: A prospective observational study was conducted for a period of 6 months. Acute Physiology and Chronic Health Evaluation IV score was recorded during the first day on intensive care unit (ICU) admission. Mortality Prediction Model II was recorded on admission, 24, 48, and 72 hours. Predicted mortality was compared with observed mortality. The systems were calibrated and tested for discriminant functions. Results: One hundred and fifty patients were studied. The observed mortality was 21.3%. The mean predicted hospital mortality by APACHE IV was 20.6%. The mean predicted hospital mortality rate by serial MPM II measurements was 27.7%, 24.3%, 25.5%, and 25.8%. The area under the receiver–operating characteristic curve was 0.87 for APACHE IV and 0.82, 0.84, 0.85, and 0.89 for MPM II series. Both systems calibrated well with similar degree of goodness of fit. Conclusion: Acute Physiology and Chronic Health Evaluation IV on admission predicted hospital mortality better than serially recorded MPM, which overestimated mortality. Also, APACHE IV had a slightly better discrimination compared to MPM II on admission. One-time recording of APACHE IV on admission may be sufficient for prognostication of ICU patients rather than serial MPM scores.

Sign in / Sign up

Export Citation Format

Share Document