scholarly journals Evaluation of mortality in ICU-hospitalized COVID-19 patients by using REMS, APACHE-II, CCI, and SOFA

2021 ◽  
Author(s):  
Meltem Songür Kodik ◽  
Esin Öztürk ◽  
İlhan Uz ◽  
Enver Özçete ◽  
Özlem Inci ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Roc Analysis ◽  
White Blood Cells ◽  
Scoring Systems ◽  
Apache Ii ◽  
Meaningful Difference ◽  
Single Centre ◽  
Failure Assessment ◽  
Comorbidity Index ◽  
The Mean

Abstract Introduction: Our study aimed to analyse the effectiveness of four scoring models in predicting mortality of intensive care unit (ICU) hospitalized COVID-19 patients. The models used in this regard were: Rapid Emergency Medicine Score (REMS), Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE-II), and the Sequential Organ Failure Assessment (SOFA).Materials and Methods: A single-centre and retrospective analysis was carried out by considering definitive or probable COVID-19 patients hospitalized our hospital’s ICU unit. Patients who were admitted to our hospital’s ED between 11.03.2020 – 31.12.2020, and transferred directly to ICU from the ED due to being diagnosed with COVID-19 were included in our study. 411 patients above 18 years old were found appropriate for the study.Results: Among the patients, the mean age was 69 and 61.6% were male. Laboratory values such as creatinine, potassium(K), white blood cells(WBC), hematocrit(HTC), pH, and physiological findings such as mean arterial pressure, systolic and diastolic blood pressure, FiO2 were found statistically significant (p<0.05). Besides, comorbidities were observed in 368(89.5%) patients, and malignancy and dementia were statistically associated with death (p<0.001 and 0.019, respectively). All four of the scoring systems (REMS, CCI, APACHE-II, and SOFA) were statistically an indicator of in-hospital mortality (p<0.001). However, when ROC analysis was used to compare the discriminatory power of the scoring systems, no meaningful difference was detected (p>0.05).Conclusion: We investigated that REMS, CCI, APACHE-II, and SOFA were effective in determining the in-hospital mortality of critically ill COVID-19 patients; however, no remarkable superiority existed between each other. These models may be guiding for ED physicians in terms of risk classification.

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.

Severity markers in patients with acute pancreatitis

Open Medicine ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. 556-564 ◽  
Author(s):  
Abdullah Kisaoglu ◽  
Bulent Aydinli ◽  
Gurkan Ozturk ◽  
Sabri Atamanalp ◽  
Bunyami Ozogul ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
High Sensitivity ◽  
Scoring Systems ◽  
Serum Levels ◽  
Apache Ii ◽  
Control Group ◽  
Correct Prediction ◽  
Total N ◽  
The Mean ◽  
The Difference

AbstractTo evaluate the effectiveness of serum levels of resistin and CD14 expression in monocytes, and high-sensitivity C-reactive protein (hsCRP) in early stages of acute pancreatitis and correct prediction of the severity of acute pancreatitis (AP) using scoring systems. The study involved 10 (29.41%) male and 24 (70.59%) female patients (total n=34) followed for AP diagnosis at the Department of General Surgery, Ataturk University Medical School between July 2008 and September 2009. In all the patients, Ranson and APACHE II scores, serum resistin, hsCRP, and monocyte CD14 expression levels were determined. The patients were divided into two groups as mild and severe AP groups. A control group was formed and the intergroup comparisons were made. Values ≥ 3 based on the Ranson scoring scale and values ≥ 8 in APACHE II scoring scale were considered to indicate severe AP. Evaluations were based on the values obtained on the 1st and 7th days for serum resistin and hsCRP levels and monocyte CD 14 expression. In 17 (50%) patients, severe AP was determined. No statistically significant differences were found between the mean serum resistin levels of AP groups, while the difference for the same parameter between the mild and severe AP groups and the control group was statistically significant. In the severe AP group, the mean 1st day and 7th day serum hsCRP levels were statistically significantly higher. The CD14 expression in monocytes was similar in all the groups. Serum hsCRP concentrations and Ranson and APACHE II scores and serum resistin and hsCRP concentrations on the 1st day were positively correlated. Serum hsCRP measurement is effective in determining the severity of acute pancreatitis. Serum resistin measurement may be a useful early marker in determining the inflammatory response in AP. However, CD14 expression in monocytes was not found to be a useful marker in the diagnosis and prediction of the disease severity in AP patients.

scholarly journals The comparison of two risk prediction models specific for COVID-19: The Brescia-COVID Respiratory Severity Scale versus the Quick COVID-19 Severity Index

2021 ◽  
pp. 1-17
Author(s):  
Rohat AK ◽  
Erdem KURT ◽  
Suphi BAHADIRLI
Keyword(s):  
Hospital Mortality ◽  
Prediction Models ◽  
Area Under The Curve ◽  
Prediction Rule ◽  
Scoring Systems ◽  
Severity Index ◽  
Severity Scale ◽  
Risk Prediction Models ◽  
Icu Admission ◽  
The Mean

Abstract Objective: This study compared the prognostic performances of the Brescia-COVID Respiratory Severity Scale (BCRSS) and the Quick COVID-19 Severity Index (qCSI) scores in hospitalized patients diagnosed with COVID-19. Methods: The data of all adult patients (over 18 years of age) who were admitted into a state hospital with confirmed COVID-19 between May 1, 2020 and October 31, 2020 were retrospectively examined. The area under the receiver operating characteristic (ROC) curve, known as the area under the curve (AUC), was used to assess the BCRSS prediction rule and the qCSI score to assess the discriminatory power in predicting in-hospital mortality and intensive care unit (ICU) admission. Results: There were 341 patients included in this study. The mean age of the patients was 58.2 ± 17.2, of which 165 were men and 176 were women, and 61.3% of patients had at least one comorbidity. The most common comorbidity was hypertension. The predictive power scores of BCRSS and qCSI were found as very good in terms of in-hospital mortality (AUC 0.804 and 0.847, respectively) and likewise in terms of ICU admission (AUC 0.842 and 0.851, respectively). Conclusion: Both BCRSS and qCSI scoring systems were found to be successful in predicting in-hospital mortality and ICU admission in our patient population.

scholarly journals Extracorporeal cytokine adsorption: Significant reduction of catecholamine requirement in patients with AKI and septic shock after cardiac surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246299
Author(s):  
Kristina Boss ◽  
Michael Jahn ◽  
Daniel Wendt ◽  
Zaki Haidari ◽  
Ender Demircioglu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cardiac Surgery ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Sofa Score ◽  
Statistical Significance ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Additional Measure ◽  
The Mean

Background Extracorporeal cytokine adsorption is an option in septic shock as an additional measure to treat a pathological immune response. Purpose of this study was to investigate the effects of extracorporeal cytokine adsorption on hemodynamic parameters in patients with acute kidney injury (AKI) on continuous renal replacement therapy (CRRT) and septic shock after cardiac surgery. Methods In this retrospective study, a total of 98 patients were evaluated. Hemoadsorption was performed by the CytoSorb® adsorber. In all patients cytokine adsorption was applied for at least 15 hours and at least one adsorber was used per patient. To compare cumulative inotrope need in order to maintain a mean arterial pressure (MAP) of ≥ 65 mmHg, we applied vasoactive score (VAS) for each patient before and after cytokine adsorption. A paired t-test has been performed to determine statistical significance. Results Before cytokine adsorption the mean VAS was 56.7 points. This was statistically significant decreased after cytokine adsorption (27.7 points, p< 0.0001). Before cytokine adsorption, the mean noradrenalin dose to reach a MAP of ≥ 65 mmHg was 0.49 μg/kg bw/min, the mean adrenalin dose was 0.12 μg/kg bw/min. After cytokine adsorption, significantly reduced catecholamine doses were necessary to maintain a MAP of ≥ 65 mmHg (0.24 μg/kg bw/min noradrenalin; p< 0.0001 and 0.07 μg/kg bw/min adrenalin; p < 0.0001). Moreover, there was a significant reduction of serum lactate levels after treatment (p< 0.0001). The mean SOFA-score for these patients with septic shock and AKI before cytokine adsorption was 16.7 points, the mean APACHE II-score was 30.2 points. The mean predicted in-hospital mortality rate based on this SOFA-score of 16.7 points was 77,0%, respectively 73,0% on APACHE II-score, while the all-cause in-hospital mortality rate of the patients in this study was 59.2%. Conclusion In patients with septic shock and AKI undergoing cardiac surgery, extracorporeal cytokine adsorption could significantly lower the need for postoperative inotropes. Additionally, observed versus SOFA- and APACHE II-score predicted in-hospital mortality rate was decreased.

scholarly journals Performance of Charlson and Elixhauser Comorbidity Index to Predict in-Hospital Mortality in Patients with Stroke in Sumadija and Western Serbia

2021 ◽  
Author(s):  
Biljana Bajic ◽  
Igor Galic ◽  
Natasa Mihailovic ◽  
Svetlana Ristic ◽  
Svetlana Radevic ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
International Classification Of Diseases ◽  
Administrative Databases ◽  
Stroke Patients ◽  
Discriminative Performance ◽  
Increased Risk ◽  
Classification Of Diseases ◽  
Comorbidity Index

Background: Comorbidities are major predictors of in-hospital mortality in stroke patients. The Charlson comorbidity index (CCI) and the Elikhauser comorbidity index (ECI) are scoring systems for classifying comorbidities. We aimed to compare the performance of the CCI and ECI to predict in-hospital mortality in stroke patients. Methods: We included patients hospitalized for stroke in the Clinical Center of Kragujevac, Serbia for the last 7 years. Hospitalizations caused by stroke, were identified by the International Classification of Diseases-10 (ICD-10) codes I60.0 - I69.9. All patients were divided into two cohorts: Alive cohort (n=3297) and Mortality cohort (n=978). Results: There were significant associations between higher CCIS and increased risk of in-hospital mortality (HR = 1.07, 95% CI = 1.01–1.12) and between higher ECIS and increased risk of in-hospital mortality (HR = 1.04, 95% CI = 0.99–1.09). Almost 2/3 patients (66.9%) had comorbidities included in the CCI score and 1/3 patients (30.2%) had comorbidities included in the ECI score. The statistically significant higher CCI score (t = -3.88, df = 1017.96, P <0.01) and ECI score (t = -6.7, df = 1447.32, P <0.01) was in the mortality cohort. Area Under the Curve for ECI score was 0.606 and for CCI score was 0.549. Conclusion: Both, the CCI and the ECI can be used as scoring systems for classifying comorbidities in the administrative databases, but the model’s ECI Score had a better discriminative performance of in-hospital mortality in the stroke patients than the CCI Score model.

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.

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.

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 Apache II score in predicting surgical outcome in patients of secondary peritonitis: a prospective and observational study

2020 ◽  
Vol 8 (4) ◽  
pp. 1505
Author(s):  
Shaukat Jeelani ◽  
Asgar Aziz ◽  
Irshad A. Kumar ◽  
Waseem A. Dar ◽  
Farzanah Nowreen
Keyword(s):  
Hospital Stay ◽  
Abdominal Cavity ◽  
Scoring Systems ◽  
Strong Relationship ◽  
Systemic Effect ◽  
Secondary Peritonitis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
The Mean ◽  
The Government

Background: Peritonitis is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. Secondary peritonitis presenting as acute generalized peritonitis is a common surgical emergency often associated with significant morbidity and mortality. Many scoring systems have been found useful in predicting the outcome in critically ill patients, thus allowing application of resources for effective use. Amongst them acute physiology and chronic health evaluation score (APACHE II), have a strong relationship to the outcome than previous groupings without consideration for systemic effect of the intra-abdominal sepsis.Methods: This study was conducted in the Department of General surgery, Sri Maharaja Hari Singh (SMHS) Hospital an associated hospital with the Government Medical College Srinagar, J&K, India. The prospective study was conducted over a period from October 2016 to September 2018 (Two Year) on 108 patients diagnosed with secondary peritonitis. Data was collected and analysed using SPSS v 20.Results: study included 108 patients with males involving 74.1% (80). The mean age of our study was 34 yr. (2-88 yr.), and 21-40 yr. (44.5%) group was mostly involved. Pain abdomen was present in 100% patients followed by nausea/vomiting (88%). Higher the APACHE VII score higher were post-operative complications (31+ score group 100%), mortality (31+ score group 100%) and less hospital stay (31+ score group 1.5 days) due to increased mortality.Conclusions: APACHE II score correlated well with postoperative complications, outcome, hospital stay. However, in patients with very high Apache score more than 30, the mean duration of hospital stay is less due to associated increased mortality during early Hospital stay.

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