scholarly journals CORRELATION BETWEEN LEVEL OF SOLUBLE FAS AND DEGREE OF SEPSIS SEVERITY BASED ON APACHE II SCORE

2018 ◽  
Vol 24 (3) ◽  
pp. 231
Author(s):  
Pauline Hadisiswoyo ◽  
Endang Retnowati ◽  
Erwin Astha Triyono
Keyword(s):  
Prediction Model ◽  
Scoring System ◽  
Linear Regression Analysis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Sepsis Severity ◽  
Cross Sectional ◽  
Chronic Health ◽  
Soluble Fas ◽  
Positive Correlations

A widely used scoring system to assess the severity of sepsis is Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II scoring system, however there are some disadvantages in using this. Other parameters are needed to predict severity and outcome of sepsis. Proinflammatory cytokines and Fas receptors are increased in sepsis and their concentration elevations are correlated with disease severity. An increase of soluble Fas level will follow increasing Fas receptors. This study aimed to prove any correlation between the level of soluble Fas and degree of sepsis severity based on APACHE II score. A cross-sectional observational study was conducted in January-June 2015 on 30 septic patients. APACHE II scores were calculated from the patients’physiological data, age, and chronic health problem status. Levels of soluble Fas were measured using the ELISA method (Human FAS/ CD95 (Factor-Related Apoptosis) ELISA Kit, Elabscience Biotechnology). Levels of soluble Fas ranged between 1,049-2,783 pg/mL (1,855.7 ± 477.27 pg/mL). APACHE II scores varied between 4-29 (17.2 ± 5.82). Significant positive correlations between levels of soluble Fas and APACHE II score (r=0.347, p=0.03) were found. A prediction model of soluble Fas levels based on APACHE II score was made. Linear regression analysis produced a prediction model of soluble Fas levels based on APACHE II score, in which soluble Fas level= 1,365.8 + 28.485 x APACHE II score.  

scholarly journals The Characteristics of Mortality Predictor Scoring for Sepsis Patients in Haji Adam Malik Hospital

2021 ◽  
Vol 8 (10) ◽  
pp. 339-344
Author(s):  
Abdul Halim Harahap ◽  
Franciscus Ginting ◽  
Lenni Evalena Sihotang
Keyword(s):  
Sofa Score ◽  
Scoring System ◽  
Scoring Systems ◽  
Developed Countries ◽  
Apache Ii ◽  
Apache Ii Score ◽  
P Value ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Score Apache

Introduction: Sepsis is a leading cause of death in the Intensive Care Unit (ICU) in developed countries and its incidence is increasing. Many scoring systems are used to assess the severity of disease in patients admitted to the ICU. SOFA score to assess the degree of organ dysfunction in septic patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system is most often used for patients admitted to the ICU. CCI scoring system to assess the effect of comorbid disease in critically ill patients on mortality. The study aimed to describe the characteristics of the use of scoring to predict patients’ mortality admitted to Haji Adam Malik Hospital. Methods: This is an observational study with a cross-sectional design. A total of 299 study subjects met the inclusion criteria and exclusion criteria, three types of scoring, namely SOFA score, APACHE II score, and CCI score were used to assess the prognosis of septic patients. Data analysis was performed using SPSS. P-value <0.05 was considered statistically significant. Results: A total of 252 people (84.3%) of sepsis patients died. The mean age of the septic patients who died was 54.25 years. The SOFA score ranged from 0-24, the median SOFA score in deceased sepsis patients was 5.0. The APACHE II score ranged from 0-71, the median APACHE II score in deceased sepsis patients was 23.0. The CCI score ranged from 0-37, the median CCI score in deceased sepsis patients was 5.0. Conclusion: Higher scores are associated with an increased probability of death in septic patients. Keywords: Sepsis; mortality predictor; SOFA score; APACHE II score, CCI score.

scholarly journals Role of acute physiology and chronic health evaluation II scoring system in risk stratification and management of small bowel perforations

2020 ◽  
Vol 7 (6) ◽  
pp. 1776
Author(s):  
Sanjana Kumar ◽  
Jainendra K. Arora ◽  
Sunil Kumar Jain
Keyword(s):  
Small Bowel ◽  
Mortality Rate ◽  
Scoring System ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Double Blind ◽  
Chronic Health ◽  
Significant Difference

Background: Despite the surgical treatment, sophisticated intensive care units, latest generation antibiotics and a better understanding of pathophysiology, the morbidity and mortality rate of perforation peritonitis are still high. Patients are usually managed by subjective decision of surgeon based on which mortality is very high.Methods: This was a double-blind observational study conducted over a period of 18 months on 50 patients with small bowel perforations. Based on the acute physiology and chronic health evaluation (APACHE) II score at presentation, patients were triaged into 3 groups: group 1 (score ≤10), group 2 (score 11 to 20) and group 3 (score >20). Study population was managed by the subjective decision of the operating surgeon who was blinded off the APACHE II score of patients. Hence removing the possibility of bias and observing a correlation between surgical outcome and APACHE II score of the patient.Results: Patients with higher APACHE II score (>10) were more likely to undergo exteriorization of bowel. Length of hospital stay was also found to be increased with an increase in score. APACHE II score of 10 was found to predict mortality with significant difference between 2 groups. Below this score the mortality was 0% and above this score the mortality rate rose to 31.25%.Conclusions: APACHE II can be used as a reliable and uniform scoring system as its assessment at presentation in patients of small bowel perforations provides an insight to their surgical management as well as predicting overall outcome. 

scholarly journals Predicting Burn Mortality Using a Simple Novel Prediction Model

2021 ◽  
Author(s):  
Sneha Sharma ◽  
Raman Tandon
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Prediction Model ◽  
Receiver Operating Characteristic ◽  
Logistic Regression Analysis ◽  
Operating Characteristic ◽  
Binary Logistic Regression ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Binary Logistic Regression Analysis

Abstract Background Prediction of outcome for burn patients allows appropriate allocation of resources and prognostication. There is a paucity of simple to use burn-specific mortality prediction models which consider both endogenous and exogenous factors. Our objective was to create such a model. Methods A prospective observational study was performed on consecutive eligible consenting burns patients. Demographic data, total burn surface area (TBSA), results of complete blood count, kidney function test, and arterial blood gas analysis were collected. The quantitative variables were compared using the unpaired student t-test/nonparametric Mann Whitney U-test. Qualitative variables were compared using the ⊠2-test/Fischer exact test. Binary logistic regression analysis was done and a logit score was derived and simplified. The discrimination of these models was tested using the receiver operating characteristic curve; calibration was checked using the Hosmer—Lemeshow goodness of fit statistic, and the probability of death calculated. Validation was done using the bootstrapping technique in 5,000 samples. A p-value of <0.05 was considered significant. Results On univariate analysis TBSA (p <0.001) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score (p = 0.004) were found to be independent predictors of mortality. TBSA (odds ratio [OR] 1.094, 95% confidence interval [CI] 1.037–1.155, p = 0.001) and APACHE II (OR 1.166, 95% CI 1.034–1.313, p = 0.012) retained significance on binary logistic regression analysis. The prediction model devised performed well (area under the receiver operating characteristic 0.778, 95% CI 0.681–0.875). Conclusion The prediction of mortality can be done accurately at the bedside using TBSA and APACHE II score.

scholarly journals Acute Physiology and Chronic Health Evaluation (APACHE) II Pada Angka Kematian Pasien Gagal Nafas

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Bambang Suryadi ◽  
Nurul Ainul Shifa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Health Evaluation ◽  
Chi Square ◽  
Cross Sectional ◽  
Chronic Health

Pendahuluan: dalam penentuan kebutuhan dan prognosis kematian pasien diperlukan skoring kematian di Intensive care unit (ICU). Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan skoring Acute Physiology And Chronic Health Evaluation (APACHE II) terhadap angka kematian pada pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor Tahun 2019. Metode: rancangan dalam penelitian ini adalah cross sectional. Jumlah sampel yaitu 56 pasien gagal nafas. Intrumen menggunakan lembar cheklist apache dan uji statistik menggunakan uji Chi Square. Hasil:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor dengan Pvalue 0,02 dan OR 4,63. Kesimpulan:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas. Diharapkan perawat membuat integrasi ICU dengan perhitungan APACHE II di ruang ICU.

scholarly journals Analysis of Factors Affecting the Weaning of Mechanical Ventilation at ICU RSUD Prof.Dr.Margono Soekarjo Purwokerto

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Etika Emaliyawati ◽  
Esti Dwi Anani ◽  
Ayu Prawesti
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Costs ◽  
Sampling Technique ◽  
Influential Factor ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Cross Sectional ◽  
Weaning Failure ◽  
Ventilation Weaning ◽  
Mechanical Ventilation Weaning

The weaning of mechanical ventilation is a complex process and depends on many factors. The failure to wean mechanical ventilation may lead to prolonged duration of mechanical ventilation, which may increase the risk of ventilator associated pneumonia (VAP), morbidity, mortality, increased hospital costs and lower quality of hospital services. In the year 2016, in ICU RSUD Prof.Dr.Margono Soekarjo Purwokerto, in average there is a 20% failure of mechanical ventilation, if not followed up will adversely affect the patient. Factors investigated in this study included patient, nurses, collaboration and organization. The purpose of this study is to analyze the factors that affect implementation of the weaning of mechanical ventilation in ICU Room Prof.Dr.Margono Soekarjo General Hospital Purwokerto.The method used in this research was descriptive quantitative analytic design with cross sectional approach on 47 mechanical ventilation weaning activities. The sample selection was conducted by accidental sampling technique. Measurements for nurses were carried out using validated values including knowledge, experience and collaboration. While the observation sheet included the implementation of standard operating procedures for mechanical ventilation weaning, collaboration, patients APACHE II score and weaning results.The result of bivariate test showed that there were influence of patient (0.000), nurse (0,021), collaboration (0,024) and organization (0,011) to mechanical ventilation weaning activity. The result of logistic regression test showed that the patient was the most influential factor on mechanical ventilation weaning activity with 87% probability.Nurses should pay more attention to patients especially with high APACHE II scores (≥20) because of the risk of mechanical ventilation weaning failure. Assessment of weaning readiness must be carried out daily with appropriate assessment. While hospitals need to revise policies on mechanical ventilation weaning procedure and continue education and training programme related to patients criticality and collaboration.

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

Does Acute Physiology and Chronic Health Evaluation II Provide a Valid Metric to Directly Compare Disease Severity in Trauma versus Surgical Intensive Care Unit Patients?

2012 ◽  
Vol 78 (11) ◽  
pp. 1261-1269
Author(s):  
Robert D. Becher ◽  
Michael C. Chang ◽  
J. Jason Hoth ◽  
Jennifer L. Kendall ◽  
H. Randall Beard ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Severity ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Chronic Health ◽  
Risk Of Death

The Acute Physiology and Chronic Health Evaluation II (APACHE II) score has never been validated to risk-adjust between critically ill trauma (TICU) and general surgical (SICU) intensive care unit patients, yet it is commonly used for such a purpose. To study this, we evaluated risk of death in TICU and SICU patients with pneumonia. We hypothesized that mortality for a given APACHE II would be significantly different and that using APACHE II to directly compare TICU and SICU patients would not be appropriate. We conducted a retrospective review of patients admitted to the TICU or SICU at a tertiary medical center over an 18-month period with pneumonia. Admission APACHE II scores, in-hospital mortality, demographics, and illness characteristics were recorded. One hundred eighty patients met inclusion criteria, 116 in the TICU and 64 in the SICU. Average APACHE II scores were not significantly different in the TICU versus SICU (25 vs 24; P = 0.4607), indicating similar disease severity; overall mortality rates, however, were significantly different (24 vs 50%; P = 0.0004). Components of APACHE II, which contributed to this mortality differential, were Glasgow Coma Score, age, presence of chronic health problems, and operative intervention. APACHE II fails to provide a valid metric to directly compare the severity of disease between TICU and SICU patients with pneumonia. These groups represent distinct populations and should be separated when benchmarking outcomes or creating performance metrics in ICU patients. Improved severity scoring systems are needed to conduct clinically relevant and methodologically valid comparisons between these unique groups.

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