scholarly journals Prediction of Outcome in Critically Ill Elderly Patients using APACHE II and SOFA Scores

2012 ◽  
Vol 40 (3) ◽  
pp. 1114-1121 ◽  
Author(s):  
Q Qiao ◽  
G Lu ◽  
M Li ◽  
Y Shen ◽  
D Xu
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Roc Curve ◽  
Sofa Score ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Failure Assessment ◽  
Mortality Outcome ◽  
Lemeshow Test ◽  
The Difference

OBJECTIVE: Performances of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score were assessed in predicting mortality outcome in critically ill elderly patients. METHODS: Mean APACHE II and SOFA scores were compared in 106 intensive care unit patients aged > 65 years classified as survivors or deaths. The discriminatory ability of the scores was evaluated using the area under the receiver operating characteristic (ROC) curve. Calibration was assessed using the Hosmer—Lemeshow test. RESULTS: Mean APACHE II and SOFA scores in survivors were lower than in those who died. There was a positive correlation between the APACHE II and SOFA scores. The area under the ROC curve was 0.76 for the APACHE II score and ranged from 0.74 for the initial SOFA score to 0.98 for the maximum SOFA score. Hosmer—Lemeshow values for the APACHE II score and various SOFA scores indicated that predictions based on these scores closely fit the observed outcomes. CONCLUSIONS: APACHE II and SOFA scores can accurately predict mortality outcome in critically ill elderly patients, especially the maximum SOFA score and the difference between the maximum and initial SOFA scores.

scholarly journals Combining Sequential Organ Failure Assessment (SOFA) Score with Acute Physiology and Chronic Health Evaluation (APACHE) II Score to Predict Hospital Mortality of Critically Ill Patients

2007 ◽  
Vol 35 (4) ◽  
pp. 515-521 ◽  
Author(s):  
K. M. Ho
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Characteristic Curve ◽  
Apache Ii ◽  
Brier Score ◽  
Apache Ii Score ◽  
Failure Assessment ◽  
Predict Hospital Mortality

The ability to accurately adjust for the severity of illness in outcome studies of critically ill patients is essential. Previous studies have showed that Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE) II score can predict hospital mortality of critically ill patients. The effects of combining these two scores to predict hospital mortality of critically ill patients has not been evaluated. This cohort study evaluated the performance of combining the APACHE II score with SOFA score in predicting hospital mortality of critically ill patients. A total of 1,311 consecutive adult patients admitted to a tertiary 22-bed multidisciplinary intensive care unit (ICU) in Western Australia were considered. The APACHE II, Admission SOFA, Delta SOFA and maximum SOFA score were all related to hospital survival in the univariate analyses. Combining Max SOFA (area under receiver operating characteristic curve 0.875 vs. 0.858, P=0.014; Nagelkerke R2: 0.411 vs. 0.371; Brier Score: 0.086 vs. 0.090) or Delta SOFA score (area under receiver operating characteristic curve 0.874 vs. 0.858, P=0.003; Nagelkerke R2: 0.412 vs. 0.371; Brier Score: 0.086 vs. 0.090) with the APACHE II score improved the discrimination and overall performance of the predictions when compared with using the APACHE II score alone, especially in the emergency ICU admissions. Combining Max SOFA or Delta SOFA score with the APACHE II score may improve the accuracy of risk adjustment in outcome studies of critically ill patients.

scholarly journals Risk factors for mortality in critically ill patients with COVID-19: a multicenter retrospective case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Gao ◽  
Li Zhong ◽  
Ming Wu ◽  
Jingjing Ji ◽  
Zheying Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Critically Ill ◽  
Sofa Score ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Survival Curve ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Hospital Death

Abstract Background Coronavirus disease 2019 (COVID-19) has spread around the world, until now, the number of positive and death cases is still increasing. Therefore, it remains important to identify risk factors for death in critically patients. Methods We collected demographic and clinical data on all severe inpatients with COVID-19. We used univariable and multivariable Cox regression methods to determine the independent risk factors related to likelihood of 28-day and 60-day survival, performing survival curve analysis. Results Of 325 patients enrolled in the study, Multi-factor Cox analysis showed increasing odds of in-hospital death associated with basic illness (hazard ratio [HR] 6.455, 95% Confidence Interval [CI] 1.658–25.139, P = 0.007), lymphopenia (HR 0.373, 95% CI 0.148–0.944, P = 0.037), higher Sequential Organ Failure Assessment (SOFA) score on admission (HR 1.171, 95% CI 1.013–1.354, P = 0.033) and being critically ill (HR 0.191, 95% CI 0.053–0.687, P = 0.011). Increasing 28-day and 60-day mortality, declining survival time and more serious inflammation and organ failure were associated with lymphocyte count < 0.8 × 109/L, SOFA score > 3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score > 7, PaO2/FiO2 < 200 mmHg, IL-6 > 120 pg/ml, and CRP > 52 mg/L. Conclusions Being critically ill and lymphocyte count, SOFA score, APACHE II score, PaO2/FiO2, IL-6, and CRP on admission were associated with poor prognosis in COVID-19 patients.

scholarly journals Dynamic Changes in Plasma Mitochondrial DNA Concentration in Patients with Severe Acute Pancreatitis

2020 ◽  
Author(s):  
Zepeng Duan ◽  
Yujing Wang ◽  
Hua Ling ◽  
Qiong Li ◽  
Xingui Dai
Keyword(s):  
Acute Pancreatitis ◽  
Mitochondrial Dna ◽  
Severe Acute Pancreatitis ◽  
Sofa Score ◽  
Early Stage ◽  
Dynamic Change ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Reactive Protein ◽  
Failure Assessment

Abstract Background: The elevated plasma mitochondrial DNA (mtDNA) is associated with prognosis in patients with severe acute pancreatitis (SAP). However, it is not clear that the dynamic process of plasma mtDNA during the early stage of SAP and the correction between mtDNA and clinical features.Methods: Twenty-six eligible patients with SAP in the general intensive care unit of our institution were enrolled in this study. The mtDNA concentration were assessed at admission and on days 3, 5, and 7.Results: The mtDNA concentration of the patients with SAP was elevated at each time point compared with that in the healthy controls. The mtDNA levels increased rapidly, peaking on day 3 after admission, and began to decrease on day 5. The trend remained statistically consistent among the acute physiology and chronic health evaluation (APACHE II) score, the sequential organ failure assessment (SOFA) score, C-reactive protein (CRP) levels and mtDNA levels. Contrastingly, the changes were not statistically consistent among the procalcitonin (PCT), calciumion (Ca2+) and mtDNA concentrations. The mtDNA level correlated significantly with the APACHE II score, SOFA score, and Ranson score, but not with the CRP, PCT, and Ca2+ concentrations. Conclusions: The dynamic change of plasma mtDNA correlated significantly with SAP development. The elevated mtDNA levels could be used as a biomarker for the early stage of SAP.Trial registration: NCT: 04079777. Registered 4 September 2019 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00096E5&selectaction=Edit&uid=U0002O5I&ts=2&cx=-e6bci8

Prognostic Value of Lactate / Albumin Ratio combined with APACHE II, SAPS II and SOFA Score for Predicting Mortality in Critically Ill Patients with Septic Shock

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Walid H Nofal ◽  
Sahar K Abo Alela ◽  
Moustafa M Aldeeb ◽  
Gamal M Elewa
Keyword(s):  
Septic Shock ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Predictive Value ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Albumin Ratio ◽  
Saps Ii ◽  
Saps Ii Score

Abstract Background Despite all worldwide efforts towards sepsis, more than 5.3 million patients die annually. Till now, there is no parameter or score to detect mortality in septic patients precisely. Objectives The aim of this study was to evaluate the prognostic performance of the lactate/albumin (L/A) ratio when combined with APACHE II score, SOFA score and SAPS II for predicting 28-day mortality in critically ill patients with septic shock. Patients and Methods After approval of the Medical Ethics Committee of Ain Shams Faculty of Medicine, an informed consent was taken from the patient or next of kin to include his/her data in this study. All patients who were admitted to the intensive care units (ICUs) with septic shock from 1st of September, 2019 to 30th of March, 2020 were assessed for enrollment in this study. Results In this prospective observational study, 100 adult patients of both sexes with septic shock were enrolled. They were categorized into two groups according to the primary endpoint (outcome) “28-days mortality”. Sixty-one patients (61%) died (non-survivors’ group) and thirtynine patients (39%) survived (survivors group). The most significant factors which affecting the mortality were LAR, SOFA score on admission, APACHE II, and SAPS II score. Prediction performance of the four variables for estimating 28 days mortality. When combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score the ROC (AUROC, 0.867,0.847,0.849,,0.899 respectively) was the highest, compared to the other single models and lower cutoff (&gt;0.48, &gt;0.53, &gt;0.42, &gt;0.47 respectively)in comparison to single scores. Moreover, the overall score (including the 4 parameters together) gave the best predictive value for 28 day mortality Conclusion Lactate/Albumin ratio combined with APACHI II, SOFA and SAPS scores gave the best predictive value for 28 day mortality in septic shock patients, when compared with each separate score Recommendations combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score recommended to use to predictho spital mortality, Further research on large sample sizeto study the risk stratification and implementing new scores using the lactate/albumin ratio (LAR) is needed. Simple, available and cheap markers should be used in developing new prediction scores.

scholarly journals Risk Factors for Mortality in Critically Ill Patients with COVID-19: A Multicenter Retrospective Case-Control Study

2020 ◽  
Author(s):  
Jinghua Gao ◽  
Li Zhong ◽  
Ming Wu ◽  
Jingjing Ji ◽  
Ziyun Shao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Critically Ill ◽  
Sofa Score ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Survival Curve ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Hospital Death

Abstract Background Coronavirus disease 2019 (COVID-19) has spread around the world and caused many deaths, but little is known about the risk factors for death in critically patients. Methods we collected demographic and clinical data on all severe inpatients with COVID-19 .We used univariable and multivariable Cox regression methods to determine the independent risk factors related to likelihood of 28-day and 60-day survival, performing survival curve analysis. Results Of 325 patients enrolled in the study, Multi-factor Cox analysis showed increasing odds of in-hospital death associated with basic illness (hazard ratio [HR] 6.455, 95% Confidence Interval [CI] 1.658–25.139, P = 0.007), lymphopenia (HR 0.373, 95% CI 0.148–0.944, P = 0.037), higher Sequential Organ Failure Assessment (SOFA) score on admission (HR 1.171, 95% CI 1.013–1.354, P = 0.033) and being critically ill (HR 0.191, 95% CI 0.053–0.687, P = 0.011). Increasing 28-day and 60-day mortality, declining survival time and more serious inflammation and organ failure were associated with lymphocyte count ≤ 0.8 × 109/L, SOFA score > 3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score > 7, PaO2/FiO2 ≤ 200 mmHg, IL-6 > 120 pg/ml, and CRP > 52 mg/L. Conclusions Being critically ill and lymphocyte count, SOFA score, APACHE II score, PaO2/FiO2, IL-6, and CRP on admission were associated with poor prognosis in COVID-19 patients.

Effectiveness of the sequential organ failure assessment, acute physiology and chronic health evaluation II, and simplified acute physiology score II prognostic scoring systems in paraquat-poisoned patients in the intensive care unit

2016 ◽  
Vol 36 (5) ◽  
pp. 431-437 ◽  
Author(s):  
Jun Ho Lee ◽  
Seong Youn Hwang ◽  
Hye Ran Kim ◽  
Yang Won Kim ◽  
Mun Ju Kang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Sofa Score ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Saps Ii ◽  
Failure Assessment ◽  
Score Apache

Objective: This study was conducted to assess the ability of the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) II scoring systems, as well as the simplified acute physiology score (SAPS) II method to predict group mortality in intensive care unit (ICU) patients who were poisoned with paraquat. This will assist physicians with risk stratification. Material and methods: The medical records of 244 paraquat-poisoned patients admitted to the ICU from January 2010 to April 2015 were examined retrospectively. The SOFA, APACHE II, and SAPS II scores were calculated based on initial laboratory data in the emergency department and during the first 24 h of ICU admission. The probability of death was calculated for each patient based on the SOFA score, APACHE II score, and SAPS II. The ability of the SOFA score, APACHE II score, and SAPS II method to predict group mortality was assessed using a receiver operating characteristic (ROC) curve and calibration analyses. Results: A total of 219 patients (mean age, 63 years) were enrolled. Sensitivities, specificities, and accuracies were 58.5%, 86.1%, and 64.0% for the SOFA, respectively; 75.1%, 86.1%, and 77.6% for the APACHE II scoring systems, respectively; and 76.1%, 79.1%, and 76.7% for the SAPS II, respectively. The areas under the curve in the ROC curve analysis for the SOFA score, APACHE II scoring system, and SAPS II were 0.716, 0.850, and 0.835, respectively. Conclusion: The SOFA, APACHE II, and SAPS II had different capabilities to discriminate and estimate early in-hospital mortality of paraquat-poisoned patients. Our results show that although the SOFA and SAPS II are easier and more quickly calculated than APACHE II, the APACHE II is superior for predicting mortality. We recommend use of the APACHE II for outcome predictions and risk stratification in paraquat-poisoned patients in the ICU.

scholarly journals Combination of Sequential Organ Failure Assessment (SOFA) score and Charlson Comorbidity Index (CCI) could predict the severity and prognosis of candidemia more accurately than the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nobuhiro Asai ◽  
Wataru Ohashi ◽  
Daisuke Sakanashi ◽  
Hiroyuki Suematsu ◽  
Hideo Kato ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Charlson Comorbidity Index ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Failure Assessment ◽  
Comorbidity Index

Abstract Background Candidemia has emerged as an important nosocomial infection, with a mortality rate of 30–50%. It is the fourth most common nosocomial bloodstream infection (BSI) in the United States and the seventh most common nosocomial BSI in Europe and Japan. The aim of this study was to assess the performance of the Sequential Organ Failure Assessment (SOFA) score for determining the severity and prognosis of candidemia. Methods We performed a retrospective study of patients admitted to hospital with candidemia between September 2014 and May 2018. The severity of candidemia was evaluated using the SOFA score and the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score. Patients’ underlying diseases were assessed by the Charlson Comorbidity Index (CCI). Results Of 70 patients enrolled, 41 (59%) were males, and 29 (41%) were females. Their median age was 73 years (range: 36–93 years). The most common infection site was catheter-related bloodstream infection (n=36, 51%).The 30-day, and in-hospital mortality rates were 36 and 43%, respectively. Univariate analysis showed that SOFA score ≥5, APACHE II score ≥13, initial antifungal treatment with echinocandin, albumin < 2.3, C-reactive protein > 6, disturbance of consciousness, and CCI ≥3 were related with 30-day mortality. Of these 7, multivariate analysis showed that the combination of SOFA score ≥5 and CCI ≥3 was the best independent prognostic indicator for 30-day and in-hospital mortality. Conclusions The combined SOFA score and CCI was a better predictor of the 30-day mortality and in-hospital mortality than the APACHE II score alone.

scholarly journals The Impact of Serum Glucose on the Predictive Value of Serum Lactate for Hospital Mortality in Critically Ill Surgical Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Xue Chen ◽  
Jianbin Bi ◽  
Jia Zhang ◽  
Zhaoqing Du ◽  
Yifan Ren ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
High Glucose ◽  
Predictive Ability ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Glucose Levels ◽  
Glucose Group

Background. Lactate has been widely used as a risk indicator of outcomes in critically ill patients due to its ready measurement and good predictive ability. However, the interconnections between lactate metabolism and glucose metabolism have not been sufficiently explored, yet. In this study, we aimed to investigate whether glucose levels could influence the predictive ability of lactate and design a more comprehensive strategy to assess the in-hospital mortality of critically ill patients. Methods. We analyzed the clinical data of 293 critically ill patients. The primary outcome was in-hospital mortality. The logistic regression analysis and the area under the receiver operating characteristic curve (AUROC) were applied to evaluate the predictive ability of lactate in association with glucose. Results. The lactate level showed significant association with in-hospital mortality, and its predictive ability was also comparable to other prognostic scores such as the SOFA score and APACHE II score. We further divided 293 patients into three groups based on glucose levels: low-glucose group (<7 mmol/L), medium-glucose group (7-9 mmol/L), and high-glucose group (>9 mmol/L). The lactate level was associated with in-hospital mortality in the low- and high- glucose groups, but not in the medium-glucose group, whereas the SOFA score and APACHE II score were associated with in-hospital mortality in all three glucose groups. The AUROC of lactate in the medium-glucose group was also the lowest among the three glucose groups, indicating a decrease in its predictive ability. Conclusions. Our findings demonstrated that the predictive ability of lactate to assess in-hospital mortality could be influenced by glucose levels. In the medium glucose level (i.e., 7-9 mmol/L), lactate was inadequate to predict in-hospital mortality and the SOFA score; the APACHE II score should be utilized as a complementation in order to obtain a more accurate prediction.

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