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 PREDICTION OF MORTALITY OF APACHE-II AND APACHE-III SCORES IN PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT (ICU) FOR INTOXICATION

2015 ◽  
Vol 3 (Suppl 1) ◽  
pp. A342
Author(s):  
E Banderas-Bravo ◽  
MD Arias-Verdú ◽  
I Macias-Guarasa ◽  
E Aguilar-Alonso ◽  
E Castillo-Lorente ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Apache Ii ◽  
Prediction Of Mortality ◽  
Apache Iii

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 The Pros and Cons of the Prediction Game: The Never-ending Debate of Mortality in the Intensive Care Unit

2019 ◽  
Vol 16 (18) ◽  
pp. 3394 ◽  
Author(s):  
Piotr A. Fuchs ◽  
Iwona J. Czech ◽  
Łukasz J. Krzych
Keyword(s):  
Intensive Care ◽  
Scoring Systems ◽  
Roc Curves ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Icu Mortality ◽  
Saps Ii ◽  
Icu Discharge ◽  
Pros And Cons ◽  
Long Term Prognosis

Background: The Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scales are scoring systems used in intensive care units (ICUs) worldwide. We aimed to investigate their usefulness in predicting short- and long-term prognosis in the local ICU. Methods: This single-center observational study covered 905 patients admitted from 1 January 2015 to 31 December 2017 to a tertiary mixed ICU. SAPS II, APACHE II, and SOFA scores were calculated based on the worst values from the first 24 h post-admission. Patients were divided into surgical (SP) and nonsurgical (NSP) subjects. Unadjusted ICU and post-ICU discharge mortality rates were considered the outcomes. Results: Baseline SAPS II, APACHE II, and SOFA scores were 41.1 ± 20.34, 14.07 ± 8.73, and 6.33 ± 4.12 points, respectively. All scores were significantly lower among SP compared to NSP (p < 0.05). ICU mortality reached 35.4% and was significantly lower for SP (25.3%) than NSP (57.9%) (p < 0.001). The areas under the receiver-operating characteristic (ROC) curves were 0.826, 0.836, and 0.788 for SAPS II, APACHE II, and SOFA scales, respectively, for predicting ICU prognosis, and 0.708, 0.709, and 0.661 for SAPS II, APACHE II, and SOFA, respectively, for post-ICU prognosis. Conclusions: Although APACHE II and SAPS II are good predictors of ICU mortality, they failed to predict survival after discharge. Surgical patients had a better prognosis than medical ICU patients.

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 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.

A PROSPECTIVE COMPARITIVE STUDY OF APACHE II AND APACHE IV IN MORTALITY PREDICTION IN ICU

2021 ◽  
pp. 38-39
Author(s):  
R Kavitha ◽  
Kiran Mayi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Study ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Age Group ◽  
Mortality And Morbidity ◽  
The Mean ◽  
Apache Iv

Various scoring systems have been developed to predict mortality and morbidity in intensive care unit, but different data has been reported so far. To compare the predicted mortality of APACHE II and AP Aims: ACHE IV. This Methodology : prospective study was conducted in 12 bed ICU center in our hospital. 57 patients were taken with age group of above 15years irrespective of diagnosis, managed in ICU for >24hrs . APACHE II and APACHE IV scores were calculated based on the worst values of the rst 24 h of admission. All enrolled patients were followed during their ICU stay Or till death and outcome was recorded as survivors or non survivors. Results : There were 40 survivors .In APACHE II the mean score for survivors was 16.39 ± 6.82, which was less compared to mean the score of 22.08 ± 7.18 for non survivors. (P = 0.001).In APACHE IV the mean score for the survivors was 83.96 ± 17.93, which was less compared with mean the score of 107.44 ± 21.53 for non survivors.(P < .001) Conclusion: Discrimination, was fair for both models, but APACHE IV was superior to APACHE II. Calibration, was better for APACHE II than APACHE IV in our ICU. There was good correlation observed between the models.

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