APACHE II, SOFA and SAPS II scoring systems in assessing survival of critically ill ICU patients

Aim: To compare the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients in terms of sensitivity, specificity and accuracy. Methodology: A prospective observational study. Intensive care unit from May 13, 2018 to September 15, 2021. For 1368 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. The cut off value for APACHE II, SAPS II and SOFA was taken as 50% of the highest possible score, with <50% expected to survive and with ≥50% expected to die during their ICU stay. Cross tables were made against real outcome of the patients, and sensitivity, specificity and accuracy for APACHE II, SAPS II and SOFA were calculated. Results: Sensitivity, specificity and accuracy were 77.53%, 94.28% and 85.45% for APACHE II scoring system; 47.29%, 87.32%, and 66.23% for SAPS II scoring system; and 73.37%, 60.28%, and 67.18% for SOFA scoring system, respectively. Conclusion: Apache Ii scoring system has highest sensitivity, specificity and accuracy in mortality prediction in ICU patients as compared to SAPS II and SOFA scoring systems, with SAPS II being least sensitive and accurate. Keywords: Sensitivity, specificity, accuracy, Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality.

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Comparative study of scoring systems in ICU and emergency department in predicting mortality of critically ill

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171225 ◽

2017 ◽

Vol 5 (4) ◽

pp. 1352 ◽

Cited By ~ 1

Author(s):

Sasi Sekhar T. V. D. ◽

Anjani Kumar C. ◽

Bhavya Ch. ◽

Sameera B. ◽

Rama Devi Ch.

Keyword(s):

Emergency Department ◽

Critically Ill ◽

Critically Ill Patients ◽

Clinical Decision Making ◽

Predictive Accuracy ◽

Laboratory Data ◽

Scoring Systems ◽

Apache Ii ◽

Early Warning Score ◽

Saps Ii

Background: Scoring systems can be used to define critically ill patients, estimate their prognosis, help in clinical decision making, and guide the allocation of resources and to estimate the quality of care. It remains unclear whether the additional data needed to compute ICU scores improves mortality prediction for critically ill patients compared to the simpler ED scores.Methods: We have done a prospective observational study of consecutively admitted 400 critically ill patients to ICU directly from Emergency Department in Dr PSIMS and RF over a period of 2 years. Clinical and laboratory data conforming to the modified early warning score (MEWS), rapid emergency medicine score (REMS), acute physiology and chronic health evaluation (APACHE II), and simplified acute physiology score (SAPS II) were recorded for all patients. A comparison was made between ED scoring systems MEWS, REMS and ICU scoring systems APACHE II, SAPSII. The outcome was recorded in two categories: survived and non-survived with a primary end point of 30-day mortality. Discrimination was evaluated using receiver operating characteristic (ROC) curves.Results: The ICU scores outperformed the ED scores with more area under curve values. The predicted mortality percentage of ICU based scoring systems is high compared to emergency scores (predicted mortality % of SAPS II-63%, APACHE II-33.3%, MEWS-18.5%, REMS-14.8%).Conclusions: ICU scores showed more predictive accuracy than ED scores in prognosticating the outcomes in critically ill patients. This difference is seemed more due to complexity of ICU scores.

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Comparison of APACHE II, SAPS II and SOFA Scoring Systems as Predictors of Mortality in ICU Patients

10.7176/jmpb/53-03 ◽

2019 ◽

Keyword(s):

Scoring Systems ◽

Apache Ii ◽

Icu Patients ◽

Predictors Of Mortality ◽

Saps Ii

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Clinical profile and outcome of obstetric ICU patients. APACHE II, SOFA, SAPS II and MPM scoring systems for prediction of prognosis

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2013.39a006 ◽

2013 ◽

Vol 03 (09) ◽

pp. 41-50 ◽

Cited By ~ 1

Author(s):

Pratibha Devabhaktuni ◽

Srinivas Samavedam ◽

Gopal V. S. Thota ◽

Saraschandrika V. Pusala ◽

Kasturibai Velaga ◽

...

Keyword(s):

Scoring Systems ◽

Clinical Profile ◽

Apache Ii ◽

Icu Patients ◽

Saps Ii ◽

Prediction Of Prognosis

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183394 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3394 ◽

Cited By ~ 3

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.

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