scholarly journals Comparison of Acute Physiology and Chronic Health Assessment II (APACHE II) Score and Sequential Organ Failure Assessment (SOFA) Score as A Mortality Predictor in ED-ICU Patients

2019 ◽  
Vol 5 (4) ◽  
pp. 225-232
Author(s):  
Hariprasad Kanakapura Veerendranath ◽  
◽  
Ravikanti Karthik ◽  
Murali Mohan NT ◽  
Gaganam Trimurty ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nobuhiro Asai ◽  
Wataru Ohashi ◽  
Daisuke Sakanashi ◽  
Hiroyuki Suematsu ◽  
Hideo Kato ◽  
...  

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.


Infection ◽  
2007 ◽  
Vol 35 (4) ◽  
pp. 240-244 ◽  
Author(s):  
C. Routsi ◽  
M. Pratikaki ◽  
C. Sotiropoulou ◽  
E. Platsouka ◽  
V. Markaki ◽  
...  

2021 ◽  
Vol 13 (2) ◽  
pp. 99-113
Author(s):  
Habibah Teniya Ariq Fauziyah ◽  
Bambang Pujo Semedi ◽  
Pudji Lestari ◽  
Maulydia Maulydia

Latar belakang: Intensive care unit (ICU) adalah suatu ruangan dari rumah sakit yang khusus untuk merawat pasien yang menderita penyakit, cedera, atau komplikasi yang mengancam jiwa. Pasien yang sedang dilakukan perawatan di ICU dapat diperkirakan prognosisnya menggunakan sistem skoring.Tujuan: Untuk mengetahui hubungan antara sistem skoring acute physiological chronic health evaluation (APACHE II), sequential organ failure assessment (SOFA) hari pertama, SOFA hari ketiga, SOFA hari kelima dengan outcome pasien di ICU RSUD Dr. Soetomo Surabaya.Metode: Prospektif studi analitik observasional. Pengumpulan data dari rekam medis ICU RSUD Dr. Soetomo Surabaya. Subjek penelitiannya adalah pasien berumur ≥17 tahun yang dirawat di ICU minimal lima hari untuk kemudian dibandingkan sistem skoring APACHE II, SOFA hari pertama, SOFA hari ketiga dan SOFA hari kelima terhadap outcome pasien. Sampel penelitian bulan September 2019 hingga Januari 2020 sebanyak 110 pasien, namun yang masuk kriteria inklusi hanya 30 pasien. Data dianalisis menggunakan software SPSS 16 menggunakan uji spearman dan scatter plot.Hasil: Dari 30 pasien ICU, 56.7% berjenis kelamin laki-laki dan 43.3% berjenis kelamin perempuan, kelompok umur terbanyak 46-65 tahun (50%), indeks massa tubuh (IMT) tertinggi pada kategori IMT Normal (60%), diagnosis terbanyak adalah Sepsis sebanyak 14 pasien. (46.7%), pasien tanpa komorbiditas lebih dominan 15 pasien (50%), kondisi akhir pasien lebih banyak pada pasien yang hidup 18 pasien (60%). Hasil uji Spearman dan scatter plot menunjukkan adanya hubungan antara SOFA hari kelima dengan outcome ICU (p <0.05).Kesimpulan: Sistem penilaian SOFA hari kelima dapat memprediksi outcome ICU. Sedangkan APACHE II dan SOFA pada hari pertama dan ketiga tidak dapat memprediksi outcome ICU.


2016 ◽  
Author(s):  
Γεώργιος Αργυρίου

Σκοπός: Η συγκριτική αξιολόγηση των προγνωστικών δεικτών βαρύτητας acute physiology and chronic health evaluation (APACHE) II και sequential organ failure assessment (SOFA) σε καρδιολογικές μονάδες εντατικής θεραπείας (ΚΜΕΘ).Μέθοδος: Πρόκειται για μονοκεντρική, προοπτική μελέτη παρατήρησης, σε ασθενείς με οξέα καρδιολογικά προβλήματα που εισήχθησαν σε ΚΜΕΘ. Τα APACHE II και SOFA υπολογίσθηκαν κατά την είσοδο των ασθενών στην ΚΜΕΘ λαμβάνοντας υπόψη τις χειρότερες τιμές του πρώτου 24ώρου νοσηλείας. Η περιοχή κάτω από την καμπύλη (AUC) χρησιμοποιήθηκε για να αξιολογήσει τη διακριτική ικανότητα των δεικτών στην πρόβλεψη της επιβίωσης στην ΚΜΕΘ, στο νοσοκομείο και 6 μήνες μετά την έξοδο από αυτό. Η βαθμονόμηση και η ακρίβεια των δεικτών ελέχθησαν με τη χρήση του Hosmer-Lemeshow (HL) test και του Brier score. Οι αναλύσεις έγιναν στο σύνολο του δείγματος και χωριστά σε ασθενείς με οξύ στεφανιαίο σύνδρομο (ΟΣΣ).Αποτελέσματα: Από τους 300 ασθενείς που εισήχθησαν οι 206 είχαν ΟΣΣ. Και οι δύο δείκτες παρουσίασαν καλή διακριτική ικανότητα (AUC εύρος 0,84-0,92) και οι AUC δε διέφεραν σημαντικά μεταξύ τους. Οι τιμές του HL test ήταν υψηλότερες (0,151-0,949 έναντι 0,033-0,531) και του Brier score κοντά στο μηδέν (0,0864-0,1570 έναντι 0,1039-0,1264) για το APACHE II σε σύγκριση με το SOFA. To APACHE II αποτέλεσε τον καλύτερο παράγοντα κινδύνου για την αξιολόγηση της θνησιμότητας στην ΚΜΕΘ (OR=1,24, 95% CI: 1,13-1,37, p<0,001).Συμπέρασμα: Τα APACHE II και SOFA έχουν καλή και συγκρίσιμη διακριτική ικανότητα για την πρόβλεψη της έκβασης. Η βαθμονόμηση και οι δείκτες ακρίβειας είναι καλύτεροι για το APACHE II.


2010 ◽  
Vol 36 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Bruno do Valle Pinheiro ◽  
Rodrigo de Oliveira Tostes ◽  
Carolina Ito Brum ◽  
Erich Vidal Carvalho ◽  
Sérgio Paulo Santos Pinto ◽  
...  

OBJETIVO: Comparar os efeitos da traqueostomia precoce e da traqueostomia tardia em pacientes com lesão cerebral aguda grave. MÉTODOS: Estudo retrospectivo com 28 pacientes admitidos na UTI do Hospital Universitário da Universidade Federal de Juiz de Fora com diagnóstico de lesão cerebral aguda grave e apresentando escore na escala de coma de Glasgow (ECG) < 8 nas primeiras 48 h de internação. Os pacientes foram divididos em dois grupos: traqueostomia precoce (TP), realizada em até 8 dias; e traqueostomia tardia (TT), realizada após 8 dias. Dados demográficos e os escores Acute Physiology and Chronic Health Evaluation (APACHE) II, ECG e Sequential Organ Failure Assessment (SOFA) do dia da admissão foram coletados. RESULTADOS: Não houve diferenças significativas em relação aos dados demográficos ou aos escores coletados nos grupos TP e TT: APACHE II (26 ± 6 vs. 28 ± 8; p = 0,37), SOFA (6,3 ± 2,7 vs. 7,2 ± 3,0; p = 0,43) e ECG (5,4 ± 1,7 vs. 5,5 ± 1,7; p = 0,87). A mortalidade em 28 dias foi menor no grupo TP (9% vs. 47%; p = 0,04). Pneumonia nosocomial precoce (até 7 dias) foi menos frequente no grupo TP, mas essa diferença não foi significativa (0% vs. 23%, p = 0,13). Não houve diferenças em relação à ocorrência de pneumonia tardia ou ao tempo de ventilação mecânica entre os grupos. CONCLUSÕES: Baseado nesses achados, a traqueostomia precoce deve ser considerada em pacientes com lesão cerebral aguda grave.


2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110119
Author(s):  
Shuai Zheng ◽  
Jun Lyu ◽  
Didi Han ◽  
Fengshuo Xu ◽  
Chengzhuo Li ◽  
...  

Objective This study aimed to identify the prognostic factors of patients with first-time acute myocardial infarction (AMI) and to establish a nomogram for prognostic modeling. Methods We studied 985 patients with first-time AMI using data from the Multi-parameter Intelligent Monitoring for Intensive Care database and extracted their demographic data. Cox proportional hazards regression was used to examine outcome-related variables. We also tested a new predictive model that includes the Sequential Organ Failure Assessment (SOFA) score and compared it with the SOFA-only model. Results An older age, higher SOFA score, and higher Acute Physiology III score were risk factors for the prognosis of AMI. The risk of further cardiovascular events was 1.54-fold higher in women than in men. Patients in the cardiac surgery intensive care unit had a better prognosis than those in the coronary heart disease intensive care unit. Pressurized drug use was a protective factor and the risk of further cardiovascular events was 1.36-fold higher in nonusers. Conclusion The prognosis of AMI is affected by age, the SOFA score, the Acute Physiology III score, sex, admission location, type of care unit, and vasopressin use. Our new predictive model for AMI has better performance than the SOFA model alone.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Gao ◽  
Li Zhong ◽  
Ming Wu ◽  
Jingjing Ji ◽  
Zheying Liu ◽  
...  

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.


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