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.

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 Assessment of Nurses’ Workload in Intensive Care Unit by Use of Scoring Systems

2020 ◽  
Vol 4 (1) ◽  
pp. 59-71
Author(s):  
Ljiljana Vuković
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Scoring System ◽  
Scoring Systems ◽  
University Hospital ◽  
Study Patient ◽  
Nursing Workload ◽  
Icu Stay ◽  
Study Results ◽  
Surgical Icu

Aim. To assess the level of correlation between two scoring systems: patient categorization according to the Croatian Nursing Council consensus and Nine Equivalents of Nursing Manpower Use Score (NEMS) and their ability to determine if the number of nurses working in the intensive care unit (ICU) is optimal to provide adequate nursing care, and to assess the level of correlation between the severity of patients’ illness and the level of nurses’ satisfaction with provided care. Methods. Research was performed in surgical ICU of the Clinical Department of Anesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Dubrava, in the period between January 8th and April 14th, 2014. 256 patients aged 18-92 years were included in the study. Patient categorization and NEMS were calculated each day during the first 7 days of the ICU stay. NEMS was calculated using a pre-made table of variables and categorization was calculated using an electronic form included in nursing electronic patient files. Satisfaction of provided care was expressed using the Likert scale (1-5). Results. Study results have shown a moderate but significant level of correlation between the categorization and NEMS scores. Mean NEMS score during the first 7 days in the ICU was 26.93 ± 4.64 and the highest measured values were at day 4 (30.34±8.1) after which they started decreasing. Mean cumulative NEMS throughout the whole ICU stay was 269.3. According to the fact that according to NEMS scoring system one nurse can provide maximum of 45 points for 24 hours, the results have shown that a 10 bed ICU needs at least 5.98 (6) nurses to provide adequate level of care. Average categorization score was 57.83±4.29 and the highest recorded score was at day 7 (59.7±4.44). According to the categorization scoring system time needed to provide care for one 4th category patient throughout 24 hours is 10 or more hours. Since the description of the 4th category doesn’t specify what is the upper limit of time needed to provide care for each patient, 14 hours was used to determine a minimum number of nurses, and according to the categorization score 5.83 (6) nurses are needed in the ICU. Nurses’ satisfaction with provided care has shown a significant negative correlation with NEMS score and categorization score. Conclusion. Both scoring systems can be used to assess nursing workload in a surgical ICU. However, NEMS is simpler and quicker to use, more applicable, useful and should be routinely used in place of categorization to assess nursing workload in surgical ICUs.

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. 

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

2019 ◽  
Vol 16 (18) ◽  
pp. 3394 ◽  
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.

scholarly journals Performance of Sequential Organ Failure Assessment and Simplified Acute Physiology Score II for Post-Cardiac Surgery Patients in Intensive Care Unit

2021 ◽  
Vol 8 ◽  
Author(s):  
Fei Xu ◽  
Weina Li ◽  
Cheng Zhang ◽  
Rong Cao
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Scoring System ◽  
Simplified Acute Physiology Score ◽  
Saps Ii ◽  
Icu Stay ◽  
Cutoff Values ◽  
Adjusted Model

Background: The aim of this study is to assess the performance of Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology Score (SAPS II) on outcomes of patients with cardiac surgery and identify the cutoff values to provide a reference for early intervention.Methods: All data were extracted from MIMIC-III (Medical Information Mart for Intensive Care-III) database. Cutoff values were calculated by the receiver-operating characteristic curve and Youden indexes. Patients were grouped, respectively, according to the cutoff values of SOFA and SAPS II. A non-adjusted model and adjusted model were established to evaluate the prediction of risk. Comparison of clinical efficacy between two scoring systems was made by decision curve analysis (DCA). The primary outcomes of this study were in-hospital mortality, 28-day mortality, 90-day mortality, and 1-year mortality after cardiac surgery. The secondary outcomes included length of hospital stay and intensive care unit (ICU) stay and the incidence of acute kidney injury (AKI) within 7 days after ICU admission.Results: A total of 6,122 patients were collected and divided into the H-SOFA group (SOFA ≥ 7) and L-SOFA group (SOFA &lt; 7) or H-SAPS II group (SAPS II ≥ 43) and L-SAPS II group (SAPS II &lt; 43). In-hospital mortality, 28-day mortality, 90-day mortality, and 1-year mortality were higher, the length of hospital and ICU stay were longer in the H-SOFA group than in the L-SOFA group (p &lt; 0.05), while the incidence of AKI was not significantly different. In-hospital mortality, 28-day mortality, 90-day mortality, 1-year mortality, and the incidence of AKI were all significantly higher in the H-SAPS II group than in the L-SAPS II group (p &lt; 0.05). Hospital stay and ICU stay were longer in the H-SAPS II group than in the L-SAPS II group (p &lt; 0.05). According to DCA, the SAPS II scoring system had more net benefits on assessing the long-term mortality compared with the SOFA scoring system.Conclusion: Exceeding the cutoff values of SOFA and SAPS II scores could lead to increased mortality and extended length of ICU and hospital stay. The SAPS II scoring system had a better discriminative performance of 90-day mortality and 1-year mortality in post-cardiac surgery patients than the SOFA scoring system. Emphasizing the critical value of the scoring system is of significance for timely treatment.

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.

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