scholarly journals Comparing APACHE II, APACHE IV, SAPS II, and SOFA Predictive Power in Poisoned Patients Admitted to the Intensive Care Unit

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Samaneh Silakhori ◽  
Bita Dadpour ◽  
Majid Khadem-Rezaiyan ◽  
Alireza Sedaghat ◽  
Farzad Mirzakhani
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring Systems ◽  
Cross Sectional Study ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Cross Sectional ◽  
Saps Ii ◽  
Hospitalization Period ◽  
Apache Iv

Background: This study aimed to assess the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiologic Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) scores in predicting mortality rate in poisoning patients admitted to an intensive care unit (ICU).Methods: This cross-sectional study was performed on all admitted patients in the poisoning ICU of Imam Reza Hospital, Mashhad City, Iran. All patients were evaluated for three consecutive days since admission time and then every two days until discharge from ICU or death. The scoring systems mentioned above were calculated and analyzed by MedCalc statistical software version 18.9.1 and SPSS version 16.Results: Overall, 150 patients were studied, out of whom 67% (101) were male. Their mean±SD age was 41.6±18.9 years. In their whole hospitalization period, APACHE II (79.5%), SAPS II (78.7%), APACHE IV (78.4%), and SOFA (72.9%) were the most precise measures. On the first day of admission APACHE II (77.4%), on the second day, APACHE II (83.1%), on the third day, APACHE II (90.7%), and on the fifth day, SOFA (81.6%) were the most precise measures.Conclusion: All four systems have acceptable discriminatory power for poisoned patients. However, it seems that APACHE II can be used for mortality prediction, especially in the early days of admission. 

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 Performance of Prognostic Scoring Systems in Trauma Patients in the Intensive Care Unit of a Trauma Center

2020 ◽  
Vol 17 (19) ◽  
pp. 7226
Author(s):  
Shao-Chun Wu ◽  
Sheng-En Chou ◽  
Hang-Tsung Liu ◽  
Ting-Min Hsieh ◽  
Wei-Ti Su ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Scoring Systems ◽  
Predictive Performance ◽  
Apache Ii ◽  
Trauma Patients ◽  
Saps Ii ◽  
Significant Difference ◽  
Prognostic Scoring Systems

Background: Prediction of mortality outcomes in trauma patients in the intensive care unit (ICU) is important for patient care and quality improvement. We aimed to measure the performance of 11 prognostic scoring systems for predicting mortality outcomes in trauma patients in the ICU. Methods: Prospectively registered data in the Trauma Registry System from 1 January 2016 to 31 December 2018 were used to extract scores from prognostic scoring systems for 1554 trauma patients in the ICU. The following systems were used: the Trauma and Injury Severity Score (TRISS); the Acute Physiology and Chronic Health Evaluation (APACHE II); the Simplified Acute Physiology Score (SAPS II); mortality prediction models (MPM II) at admission, 24, 48, and 72 h; the Multiple Organ Dysfunction Score (MODS); the Sequential Organ Failure Assessment (SOFA); the Logistic Organ Dysfunction Score (LODS); and the Three Days Recalibrated ICU Outcome Score (TRIOS). Predictive performance was determined according to the area under the receiver operator characteristic curve (AUC). Results: MPM II at 24 h had the highest AUC (0.9213), followed by MPM II at 48 h (AUC: 0.9105). MPM II at 24, 48, and 72 h (0.8956) had a significantly higher AUC than the TRISS (AUC: 0.8814), APACHE II (AUC: 0.8923), SAPS II (AUC: 0.9044), MPM II at admission (AUC: 0.9063), MODS (AUC: 0.8179), SOFA (AUC: 0.7073), LODS (AUC: 0.9013), and TRIOS (AUC: 0.8701). There was no significant difference in the predictive performance of MPM II at 24 and 48 h (p = 0.37) or at 72 h (p = 0.10). Conclusions: We compared 11 prognostic scoring systems and demonstrated that MPM II at 24 h had the best predictive performance for 1554 trauma patients in the ICU.

Comparison of Sensitivity, Specificity and Accuracy of APACHE II, SAPS II and SOFA Scoring Systems as Predictors

2021 ◽  
Vol 15 (12) ◽  
pp. 3364-3366
Author(s):  
Aamir Furqan ◽  
Mehwish Naseer ◽  
Rafia Tabassum
Keyword(s):  
Intensive Care ◽  
Scoring System ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Icu Patients ◽  
Saps Ii ◽  
Icu Stay ◽  
Study Results ◽  
Sensitivity Specificity

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.

Evaluation of illness severity scoring systems and risk prediction in vascular intensive care admissions

Vascular ◽  
2016 ◽  
Vol 24 (4) ◽  
pp. 390-403 ◽  
Author(s):  
M Dover ◽  
Wael Tawfick ◽  
Niamh Hynes ◽  
Sherif Sultan
Keyword(s):  
Intensive Care ◽  
Clinical Decision Making ◽  
Characteristic Curve ◽  
Scoring Systems ◽  
Apache Ii ◽  
Multiple Organ Dysfunction Score ◽  
Vascular Intervention ◽  
Saps Ii ◽  
Operative Severity Score ◽  
Apache Iv

IntroductionThis study examines the predictive value of intensive care unit (ICU) scoring systems in a vascular ICU population.MethodsFrom April 2005 to September 2011, we examined 363 consecutive ICU admissions. Simplified Acute Physiology Score II (SAPS II), Acute Physiology and Chronic Health Evaluation II (APACHE II), APACHE IV, Multiple Organ Dysfunction Score (MODS), organ dysfunctions and/or infection (ODIN), mortality prediction model (MPM) and physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM) were calculated. The Glasgow Aneurysm Score (GAS) was calculated for patients with aneurysm-related admissions.ResultsOverall mortality for complex vascular intervention was 11.6%. At admission, the areas under the receiver operating characteristic curve (AUCs) was 0.884 for SAPS II, 0.894 for APACHE II, 0.895 for APACHE IV, 0.902 for MODS, 0.891 for ODIN and 0.903 for MPM. At 24 h, model discrimination was best for POSSUM (AUC = 0.906) and MPM (AUC = 0.912).ConclusionThe good discrimination of these scoring systems indicates their value as an adjunct to clinical assessment but should not be used on an individual basis as a clinical decision-making tool.

scholarly journals The comparison of apache II and apache IV score to predict mortality in intensive care unit in a tertiary care hospital

2019 ◽  
Vol 7 (5) ◽  
pp. 1598
Author(s):  
Vidya S. Nagar ◽  
Basavaraj Sajjan ◽  
Rudrarpan Chatterjee ◽  
Nitesh M. Parab
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Mortality Rates ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Youden Index ◽  
Apache Ii Score ◽  
Care Hospital ◽  
Apache Iv

Background: The prognostication of critically ill patients, in a systematic way, based on definite objective data is an integral part of the quality of care in Intensive Care Unit (ICU). Acute physiology and chronic health evaluation (APACHE) scoring systems provide an objective means of mortality prediction in Intensive Care Unit (ICU). The aims of this study were to compare the performance of APACHE II and APACHE IV in predicting mortality in our intensive care unit (ICU).Methods: A prospective observational study was conducted in a 13 bedded intensive care unit (ICU) of a tertiary level teaching hospital. All the patients above the age of 12 years, irrespective of diagnosis managed in ICU for >24hours were enrolled. APACHE II and APACHE IV scores were calculated based on the worst values in the first 24hours of admission. All enrolled patients were followed up, and outcome was recorded as survivors or non survivors. Observed mortality rates were compared with predicted mortality rates for both the APACHE II and APACHE IV. Receiver operator characteristic curves (ROC) were used to compare accuracy of the two scores.Results: APACHE II score of the patients ranged from 1 to 32 and APACHE IV score of the patients ranged from 25 to 142. There was good correlation between APACHE II and APACHE IV scores with the spearman’s rho value of 0.776 (P<0.01). Discrimination for APACHE II and APACHE IV models were good with area under ROC curve of 0.805 and 0.832 respectively. APACHE IV was more accurate than APACHE II in this regard. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV were 72 respectively for predicting mortality.Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in present study. There was good correlation between the two models observed in present study.

scholarly journals Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and one year mortality prediction in a mixed intensive care unit in Poland: a cohort study

2020 ◽  
Author(s):  
Szymon Czajka ◽  
Katarzyna Ziębińska ◽  
Konstanty Marczenko ◽  
Barbara Posmyk ◽  
Anna Szczepańska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Diagnostic Accuracy ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Post Discharge ◽  
Saps Ii ◽  
Apache Iii

Abstract Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.78; 95%CI 0.73-0.83), APACHE III (AUC=0.79; 95%CI 0.74-0.84) and SAPS II (AUC=0.79; 95%CI 0.74-0.84); as well as mortality after hospital discharge (p<0.05): APACHE II (AUC=0.71; 95%CI 0.64-0.78), APACHE III (AUC=0.72; 95%CI 0.65-0.78) and SAPS II (AUC=0.69; 95%CI 0.62-0.76), with no statistically significant difference between the scores (p>0.05). The calibration of the scores was good. Conclusions. All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

scholarly journals Validation of APACHE II, APACHE III and SAPS II scores in in-hospital and one year mortality prediction in a mixed intensive care unit in Poland: a cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Szymon Czajka ◽  
Katarzyna Ziębińska ◽  
Konstanty Marczenko ◽  
Barbara Posmyk ◽  
Anna J. Szczepańska ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Diagnostic Accuracy ◽  
Mortality Prediction ◽  
Apache Ii ◽  
Post Discharge ◽  
Saps Ii ◽  
Apache Iii

Abstract Background There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12–24), 67 (36.5–88) and 44 (27–56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1–46.0), 18.5% (IQR 3.8–41.8) and 34.8% (IQR 7.9–59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p < 0.05): APACHE II (AUC = 0.78; 95%CI 0.73–0.83), APACHE III (AUC = 0.79; 95%CI 0.74–0.84) and SAPS II (AUC = 0.79; 95%CI 0.74–0.84); as well as mortality after hospital discharge (p < 0.05): APACHE II (AUC = 0.71; 95%CI 0.64–0.78), APACHE III (AUC = 0.72; 95%CI 0.65–0.78) and SAPS II (AUC = 0.69; 95%CI 0.62–0.76), with no statistically significant difference between the scores (p > 0.05). The calibration of the scores was good. Conclusions All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

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