scholarly journals Comparing the APACHE II, SOFA, LOD, and SAPS II scores in patients who have developed a nosocomial infection

2014 ◽  
Vol 2 (1) ◽  
pp. 4-9
Author(s):  
Ahmed Haddadi ◽  
Mohamed Ledmani ◽  
Marc Gainier ◽  
Hubert Hubert ◽  
P Lafaye De Micheaux
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Sofa Score ◽  
Apache Ii ◽  
Apache Ii Score ◽  
The Third ◽  
Saps Ii ◽  
Icu Stay ◽  
Logistic Organ Dysfunction ◽  
Saps Ii Score

Background: There have been numerous scores intended to evaluate the severity of patients’ condition upon admission and during their intensive care unit (ICU) stay. However, to our knowledge, no study has ever evaluated the predictive abilities of these scores among nosocomial patients during their ICU stay. The aim of our study is to compare the predictive performances of the Acute Physiology, and, Chronic Health Evaluation (APACHE II) score, Simplified Acute Physiologic Score (SAPS II), Logistic Organ Dysfunction (LOD), and Sequential Organ Failure Assessment (SOFA) scores among intensive care patients who have developed a nosocomial infection. Methods: The study is monocentric and retrospective. The APACHE II, SAPS II, LOD, and SOFA scores were reported from the third day of the patient’s hospital stay, preceding the diagnosis of the first nosocomial event up to the third post diagnosis day. Results: Out of 46 patients contracting at least one ICU-acquired infection, the multiple analyses indicated that on the day of diagnosis, the SOFA score is the most predictive (odds ratio [OR]: 12.3; 95% confidence interval [CI]: 2.33–64.91). The second most predictive was the APACHE II score (OR: 8.29; 95% CI: 1.43–48.14). The third and fourth most predictive were the LOD score (OR: 4.06; 95% CI: 0.81–20.26) and the SAPS II score (OR: 2.26; 95% CI: 0.55–9.24), respectively. Conclusion: The analysis of the receiver operating characteristic areas under the curve of the reported scores in the present study showed that the best predictive performance is in favor of the SOFA score. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19949 Bangladesh Crit Care J March 2014; 2 (1): 4-9

Prognostic Value of Lactate / Albumin Ratio combined with APACHE II, SAPS II and SOFA Score for Predicting Mortality in Critically Ill Patients with Septic Shock

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Walid H Nofal ◽  
Sahar K Abo Alela ◽  
Moustafa M Aldeeb ◽  
Gamal M Elewa
Keyword(s):  
Septic Shock ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Predictive Value ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Albumin Ratio ◽  
Saps Ii ◽  
Saps Ii Score

Abstract Background Despite all worldwide efforts towards sepsis, more than 5.3 million patients die annually. Till now, there is no parameter or score to detect mortality in septic patients precisely. Objectives The aim of this study was to evaluate the prognostic performance of the lactate/albumin (L/A) ratio when combined with APACHE II score, SOFA score and SAPS II for predicting 28-day mortality in critically ill patients with septic shock. Patients and Methods After approval of the Medical Ethics Committee of Ain Shams Faculty of Medicine, an informed consent was taken from the patient or next of kin to include his/her data in this study. All patients who were admitted to the intensive care units (ICUs) with septic shock from 1st of September, 2019 to 30th of March, 2020 were assessed for enrollment in this study. Results In this prospective observational study, 100 adult patients of both sexes with septic shock were enrolled. They were categorized into two groups according to the primary endpoint (outcome) “28-days mortality”. Sixty-one patients (61%) died (non-survivors’ group) and thirtynine patients (39%) survived (survivors group). The most significant factors which affecting the mortality were LAR, SOFA score on admission, APACHE II, and SAPS II score. Prediction performance of the four variables for estimating 28 days mortality. When combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score the ROC (AUROC, 0.867,0.847,0.849,,0.899 respectively) was the highest, compared to the other single models and lower cutoff (>0.48, >0.53, >0.42, >0.47 respectively)in comparison to single scores. Moreover, the overall score (including the 4 parameters together) gave the best predictive value for 28 day mortality Conclusion Lactate/Albumin ratio combined with APACHI II, SOFA and SAPS scores gave the best predictive value for 28 day mortality in septic shock patients, when compared with each separate score Recommendations combined LAR + SOFA, LAR + APACHE, LAR + SAPS II, Overall score recommended to use to predictho spital mortality, Further research on large sample sizeto study the risk stratification and implementing new scores using the lactate/albumin ratio (LAR) is needed. Simple, available and cheap markers should be used in developing new prediction scores.

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.

scholarly journals Study of spectrum of sepsis and prediction of its outcome in patients admitted to ICU using different scoring systems

2019 ◽  
Vol 6 (1) ◽  
pp. 155
Author(s):  
Ravi K. ◽  
Vinay K. ◽  
Akhila Rao K.
Keyword(s):  
Scoring Systems ◽  
Apache Ii ◽  
Sepsis Group ◽  
Receiver Operating Curve ◽  
Apache Ii Score ◽  
Chi Square ◽  
Mortality And Morbidity ◽  
Saps Ii ◽  
Saps Ii Score ◽  
Chi Square Test

Background: Although sepsis is one of the leading causes of mortality in hospitalized patients, information regarding early predictive factors for mortality and morbidity is limited. The aim was to identify reliable and early prognostic variables predicting mortality in patients admitted to ICU with sepsis.Methods: Patients fulfilling the Surviving Sepsis Campaign 2012 guidelines criteria for sepsis within the ICU were included over two years. Apart from baseline haematological, biochemical and metabolic parameters, APACHE II, SAPS II and SOFA scores were calculated on day 1 of admission. Patients were followed till death or discharge from the ICU. Chi-square test, student t-test, receiver operating curve analyses were done.Results: 100 patients were enrolled during the study period. The overall mortality was 35% (68.6% in males and 31.4% in females). Mortality was 88.6% and 11.4% in patients with septic shock and severe sepsis and none in the sepsis group, respectively. On multivariate analysis, significant predictors of mortality were APACHE II score greater than 27, SAPS II score greater than 43 and SOFA score greater than 11 on day the of admission. On ROC analysis APACHE II had the highest sensitivity (92.3%) and SAPS II had the highest specificity (82.9%).Conclusions: All three scores performed well in predicting the mortality. Overall, APACHE II had highest sensitivity, hence was the best predictor of mortality in critically ill patients. SAPS II had the highest specificity, hence it predicted improvement better than death. SOFA had intermediate sensitivity and specificity.

scholarly journals Acute pulmonary oedema in chronic dialysis patients, causes, clinical course and outcome admitted into emergency department

2017 ◽  
Vol 4 (6) ◽  
pp. 1541
Author(s):  
Jimnaz P. A. ◽  
Ajmal Abdul Kharim
Keyword(s):  
Intensive Care ◽  
Weight Gain ◽  
Pulmonary Oedema ◽  
Sofa Score ◽  
Clinical Course ◽  
Chronic Dialysis ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Acute Pulmonary Oedema ◽  
Interdialytic Weight Gain

Background: Chronic dialysis (CD) patient are at increased risk of multiple organ dysfunction. Recent study, estimated that 2% of CD patients require intensive care unit (ICU) admission every year. Acute Pulmonary Oedema is major cause for ICU admissions, objective of the study is to determine the cause, clinical course and outcome of APO in CD patients admitted in Intensive Care Units under Emergency Department.Methods: Prospective and observational study conducted for 1 year in our institute, a tertiary care centre, was done on chronic dialysis(CD) who presented with Acute pulmonary oedema(APO) for determine cause for APO, severity of outcome by APACHE II and sofa score. Data was entered in Microsoft Excel spread sheet and analyzed using SPSS software. Descriptive analysis and chi square test was done.Results: Study included 100 CD patients. Main etiologic factor of CKD was T2DM 56%. Etiology of APO in this study showed as 34% are due to excessive interdialytic weight gain. Only 4 patients were assessed by SOFA score and high sofa score no patients had expired. Study showed survived patients got mean APACHE II score of 24±3.4 and expired patients got mean APACHE II score of 32.9±2.5, with a significant P value <0.001.Conclusions: Main etiology of APO in CD patients were excessive interdialytic weight gain 34 %. APACHE II score as outcome predictors. APACHE II score of more than 30 have poor outcome 

Predictive Values of Initial Severity Scores at Intensive Care Unit Admission for Patients With Overnight or Prolonged Stay

2021 ◽  
Author(s):  
Koji Hosokawa ◽  
Nobuaki Shime
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Predictive Value ◽  
Apache Ii ◽  
Icu Patients ◽  
Prolonged Stay ◽  
Saps Ii ◽  
Icu Stay ◽  
Severity Scores

Abstract Background: The predictive value of disease severity scores for intensive care unit (ICU) patients is occasionally inaccurate because ICU patients with mild symptoms are also considered. We, thus, aimed to evaluate the accuracy of severity scores in predicting mortality of patients with complicated conditions admitted for > 24 hours. Methods: Overall, 35,353 adult patients using nationwide ICU data were divided into two groups: (1) overnight ICU stay after elective surgery and alive on discharge within 24 hours and (2) death within 24 hours or prolonged stay. The performance and accuracy of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II and III, and Simplified Acute Physiology Score (SAPS) II scores in predicting in-hospital mortality were evaluated. Results: In the overnight stay group, the correlation between SOFA and APACHE III scores or SAPS II was low because many had a SOFA score of 0. In the prolonged stay group, the predictive value of SAPS II and APACHE II and III showed high accuracy but that of SOFA was moderate. Conclusions: When overnight ICU stay patients were not included, the high predictive value for in-hospital mortality of SAPS II and APACHE II and III was evident.

scholarly journals Predictors of Physician Confidence to Diagnose Pneumonia and Determine Illness Severity in Ventilated Patients. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

2005 ◽  
Vol 33 (1) ◽  
pp. 112-119 ◽  
Author(s):  
R. J. Boots ◽  
J. Lipman ◽  
R. Bellomo ◽  
D. Stephens ◽  
R. F. Heller
Keyword(s):  
Intensive Care ◽  
Sofa Score ◽  
Clinical Signs ◽  
Illness Severity ◽  
Diagnostic Methods ◽  
Diagnostic Confidence ◽  
Saps Ii ◽  
Saps Ii Score ◽  
Life Threatening ◽  
Ventilated Patients

The manner in which elements of clinical history, physical examination and investigations influence subjectively assessed illness severity and outcome prediction is poorly understood. This study investigates the relationship between clinician and objectively assessed illness severity and the factors influencing clinician's diagnostic confidence and illness severity rating for ventilated patients with suspected pneumonia in the intensive care unit (ICU). A prospective study of fourteen ICUs included all ventilated admissions with a clinical diagnosis of pneumonia. Data collection included pneumonia type – community-acquired (CAP), hospital-acquired (HAP) and ventilator-associated (VAP), clinician determined illness severity (CDIS), diagnostic methods, clinical diagnostic confidence (CDC), microbiological isolates and antibiotic use. For 476 episodes of pneumonia (48% CAP, 24% HAP, 28% VAP), CDC was greatest for CAP (64% CAP, 50% HAP and 49% VAP, P<0.01) or when pneumonia was considered “life-threatening” (84% high CDC, 13% medium CDC and 3% low CDC, P<0.001). “Life-threatening” pneumonia was predicted by worsening gas exchange (OR 4.8, CI 95% 2.3–10.2, P<0.001), clinical signs of consolidation (OR 2.0, CI 95% 1.2–3.2, P<0.01) and the Sepsis-Related Organ Failure Assessment (SOFA) Score (OR 1.1, CI 95% 1.1–1.2, P<0.001). Diagnostic confidence increased with CDIS (OR 16.3, CI 95% 8.4–31.4, P<0.001), definite pathogen isolation (OR 3.3, CI 95% 2.0–5.6) and clinical signs of consolidation (OR 2.1, CI 95% 1.3–3.3, P=0.001). Although the CDIS, SOFA Score and the Simplified Acute Physiologic Score (SAPS II) were all associated with mortality, the SAPS II Score was the best predictor of mortality (P=0.02). Diagnostic confidence for pneumonia is moderate but increases with more classical presentations. A small set of clinical parameters influence subjective assessment. Objective assessment using SAPS II Scoring is a better predictor of mortality.

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 Hemostasis and inflammation in patients with polytrauma

2021 ◽  
Vol 17 (8) ◽  
pp. 66-72
Author(s):  
O.V. Filyk ◽  
M.B. Vyshynska
Keyword(s):  
Intensive Care ◽  
Health Status ◽  
Body Temperature ◽  
Injury Severity ◽  
Inverse Correlation ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Positive Correlation ◽  
Icu Stay ◽  
Length Of Icu Stay

Background. Causes of death due to severe injuries are both injuries incompatible with life and severe bleedings. Trauma-induced coagulopathy is usually found in 46 % of patients at the scene and in 60 % of individuals upon admission to the hospital. The purpose of the study was to establish the relationship between systemic inflammatory response syndrome (SIRS) and vascular-platelet and coagulation hemostasis parameters in patients with polytrauma. Materials and methods. We completed a prospective observational study and included 20 patients aged 19 to 55 years with polytrauma who were admitted to the Department of Anesthesiology with Intensive Care at Lviv City Clinical Hospital No. 8. Patients’ state was evaluated according to the Injury Severity Score (ISS) and Acute Physiology and Chronic Health Evaluation (APACHE II) score. We also took into account the duration of SIRS, the length of intensive care unit (ICU) stay, and hospital stay. Stages of the study: the day of admission to ICU (d1), the third day (d3), the fifth day (d5). The major clinical markers evaluated were: SIRS parameters, vascular-platelet hemostasis (intravascular platelet activation, adrenaline- and adenosine diphosphate-induced platelet aggregation), coagulation hemostasis (international normalized ratio, activated partial thromboplastin time, level of total fibrinogen and D-dimers). Statistical analysis was performed using variation statistics methods. The correlation dependence was performed with Spearman’s rank correlation coefficient. We determined significance level (p), and the differences were considered statistically significant at p < 0.05. Results. We have found a significant (p < 0.05) positive correlation between discocytes to spherocytes ratio and the level of total fibrinogen on stage d1, as well as a tendency (p = 0.09) to the presence of a positive correlation between this ratio and the patient’s body temperature. There was a significant (p < 0.05) inverse correlation between this ratio and the patient’s health status according to APACHE II, and a direct significant (p < 0.05) correlation with the length of ICU stay, as well as trends to an inverse correlation with the severity of injuries according to ISS (p = 0.07) and to a direct correlation with the duration of SIRS (p = 0.12). Conclusions. Patients with polytrauma had a significant (p < 0.05) positive correlation between the discocytes to spherocytes ratio and level of total fibrinogen, a tendency (p = 0.09) to a positive correlation between this ratio and the patient’s body temperature, a significant (p < 0.05) inverse correlation with the patient’s health status according to APACHE II, a direct significant (p < 0.05) correlation with the length of ICU stay, a trend (p = 0.07) to an inverse correlation with the severity of injuries according to ISS and a tendency (p = 0.12) to a direct correlation with duration of SIRS.

scholarly journals A Comparison of Severity Systems APACHE II and SAPS II in Critically ill Patients

2013 ◽  
Vol 1 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Mohammad Omar Faruq ◽  
Mohammad Rashed Mahmud ◽  
Tanjima Begum ◽  
ASM Areef Ahsan ◽  
Kaniz Fatema ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Goodness Of Fit ◽  
Care Quality ◽  
Apache Ii ◽  
Goodness Of Fit Test ◽  
Saps Ii ◽  
Icu Discharge ◽  
Saps Ii Score

Objective: To assess the performance of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in Bangladeshi critically ill patients. Material and Method: Prospective observational cohort study conducted between January 1, 2008 and December 31, 2008 in the Intensive Care Unit (ICU) of BIRDEM Hospital, an 600-beds tertiary referral Postgraduate hospital and October to December 2008 in ICU, Ibn Sina Hospital Dhaka. Results: One hundred ninety four patients were enrolled. There were 58 deaths (42.65%) at ICU discharge. APACHE II and SAPS II predicted hospital mortality 35.32 ± 21.81and 37.11 ± 27.34 respectively. Both models showed excellent discrimination. The overall discriminatory capability, as measured by the aROC, was generally good for two models and ranged from 0.78 to 0.89. APACHE II is slightly better compared to SAPS II score but not significantly better than SAPS II. Both systems exhibited good calibration ( = 8.304, p = 0.40 for APACHE II, = 9.040, p = 0.34 for SAPS II). Hosmer- Lemeshow goodness-of-fit test revealed a good performance for APACHE II scores. Conclusion: APACHE II provided better performance than SAPS II in predicting mortality in our ICU patients but SAPS II also performed well. Our observed mortality was similar with the predicted mortality from APACHE II and SAPS II scores, which suggests that the result of this study reveals good intensive care quality. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14362 Bangladesh Crit Care J March 2013; 1: 27-32

scholarly journals Mortality rate of ICU patients according to APACHE II and SAPS II score

2018 ◽  
Vol 4 (4) ◽  
pp. 219
Author(s):  
Ariadni Kostoglou ◽  
Anastasia Kotanidou ◽  
Christina Marvaki ◽  
Stylianos Orfanos
Keyword(s):  
Disease Classification ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Continuous Variables ◽  
Saps Ii ◽  
Prediction Of Mortality ◽  
Confounding Variables ◽  
Saps Ii Score ◽  
Kolmogorov Smirnov ◽  
Trauma Mortality

Introduction:  Two of the most important systems measuring the severity of disease classification in Intensive Care Unit (ICU) are APACHE II and SAPS II. The scores that the two systems generate can be the cause of increased mortality.Aim: of subject study is to record mortality of 28 days in ICU of a Hospital located in Piraeus and to investigate its dependence on the variables APACHE II and SAPS II. Material and Methods: Population of the study consisted of 200 patients, older than 18 years, admitted to ICU. The application of normal distribution for continuous variables has been evaluated based on Kolmogorov-Smirnov parametric analysis.Results: 62, 5% of the sample were male, while 37,5% were female. The average age of patients participating in the study was 58,02 years ± 19,085, average APACHE II score 22,33 ± 8,038 and average SAPS II score 37,03 ± 16,169. 51,5% of those patients were diagnosed with pathological problems, 25,5% with surgical problems and 23% had trauma. Mortality in ICU was 32%. The area below ROC curve for the prediction of mortality from APACHE II score was 0.748 (95% confidence interval: 0.684-0.808, p<0.001). Conclusions : From the regression ran  based on multiple confounding variables (age, gender, diagnosis, APACHE II and SAPS II scores) we conclude that mortality of 28 days in a polyvalent ICU is affected only by APACHE II score, which predicted independently (p= 0.036) the mortality of the patients of the present study.

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