Abstract
References
- Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med 2006; 34: 1297-310.
- Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993; 270: 2957-63.
- Moreno RP, Metnitz PG, Almeida E, et al. From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med 2005; 31: 1345-55.
- Metnitz PG, Moreno RP, Almeida E, et al. From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description. Intensive Care Med 2005; 31: 1336-44.
- Higgins TL, Kramer AA, Nathanson BH, Copes W, Stark M, Teres D. Prospective validation of the intensive care unit admission Mortality Probability Model (MPM0-III). Crit Care Med 2009; 37: 1619-23.
- Castella X, Artigas A, Bion J, Kari A. A comparison of severity of illness scoring systems for intensive care unit patients: results of a multicenter, multinational study. The European/North American Severity Study Group. Crit Care Med 1995; 23: 1327-35.
- Poole D, Rossi C, Latronico N, Rossi G, Finazzi S, Bertolini G. Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better? Intensive Care Med 2012; 38: 1280-8.
- MD CALC. APACHE II Score-Estimates ICU mortality. Available online: https://www.mdcalc.com/calc/1868/apache-ii-score (accessed Feb 2022)
- Intensve Cate Network. Available online: https://intensivecarenetwork.com (accessed Feb 2022)
- ClinCalc. SAPS II Calculator Simplified Acute Physiology Score (SAPS) II calculator to predict hospital mortality. Available online: https://clincalc.com/IcuMortality/SAPSII.aspx (accessed Feb 2022)
- UpToDate. Calculator: Mortality Probability Admission Model (MPM0-III) for critical illness in adults. Available online: https://www.uptodate.com/contents/calculator-mortality-probability-admission-model-mpm0-iii-for-critical-illness-in-adults (accessed Feb 2022
- Keegan MT, Gajic O, Afessa B. Severity of illness scoring systems in the intensive care unit. Crit Care Med 2011; 39: 163-9.
- Freire P, Romãozinho JM, Amaro P, Ferreira M, Sofia C. Prognostic scores in a gastroenterology intensive care unit. Rev Esp Enferm Dig 2010; 102: 596-601.
- Akavipat P, Thinkhamrop J, Thinkhamrop B, Sriraj W. Acute Physİology And Chronİc Health Evaluatİon (APACHE) II Score-the clinical predictor in neurosurgıial intensive care unit. Acta Clin Croat 2019; 58: 50-6.
- Godinjak A, Iglica A, Rama A, et al. Predictive value of SAPS II and APACHE II scoring systems for patient outcome in a medical intensive care unit. Acta Med Acad 2016; 45: 97-103.
- Gürsoy G, Gürsoy C, Kuşcu Y, Gümüş Demirbilek S. APACHE II or INCNS to predict mortality in traumatic brain injury: A retrospective cohort study. Ulus Travma Acil Cerrahi Derg 2020; 26: 893-8
- Gai X, Wang Y, Gao D, Ma J, Zhang C, Wang Q. Risk factors for the prognosis of patients with sepsis in intensive care units. PLoS One 2022 6;17: e0273377.
- Liu C, Suo S, Luo L, Chen X, Ling C, Cao S. SOFA Score in relation to Sepsis: Clinical Implications in Diagnosis, Treatment, and Prognostic Assessment. Comput Math Methods Med 2022 ; 2022: 7870434.
- Argyriou G, Vrettou CS, Filippatos G, Sainis G, Nanas S, Routsi C. Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit. J Crit Care 2015; 30: 752-7
- Vincent JL, Sakr Y, Sprung CL, et al. Sepsis Occurrence in Acutely Ill Patients Investigators. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 2006 ; 34: 344-53.
Comparison of predictive scoring systems in patients hospitalized in the internal medicine intensive care unit
Abstract
Aim: Various scoring systems have been developed to predict mortality, disease severity, and length of stay of patients in intensive care units. It is important to demonstrate the validity of these scores in the society in which they are used. This study aims to evaluate the effects of The Acute Physiologic and Chronic Evaluation (APACHE)-II, APACHE-IV, The Simplified Acute Physiologic Score (SAPS), and Mortality Prediction Model (MPM0) scores on mortality in the internal medicine intensive care unit.
Material and Method: The patients who were followed up in an internal medicine intensive care unit between June 2021 and December 2021 in a tertiary hospital in Turkey were included in this study. The scores were calculated at the time they were admitted to the intensive care unit. 115 patients who were followed up in the internal medicine intensive care unit for 6 months were included. The patients were divided into two groups alive or deceased. 52 (45.2%) patients in the survivor group and 63 (54.8%) patients in the deceased group were included. Patients received no study-related medical intervention.
Results: When all four prognostic scoring systems were analyzed according to the median cut-off values, rising values were related to mortality with statistical significance (p<0.001). Hosmer-Lemeshow (HL) test p values in the univariate logistic regression model (higher than the others) showed that the APACHE IV had a better calibration than the other scores. However, the H-L p values of all scores were above 0.05.
Conclusion: Although all scoring systems are good predictors of mortality in patients in internal medicine intensive care units, none of them is superior to the other for mortality prediction.
References
- Zimmerman JE, Kramer AA, McNair DS, Malila FM. Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients. Crit Care Med 2006; 34: 1297-310.
- Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 1993; 270: 2957-63.
- Moreno RP, Metnitz PG, Almeida E, et al. From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med 2005; 31: 1345-55.
- Metnitz PG, Moreno RP, Almeida E, et al. From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description. Intensive Care Med 2005; 31: 1336-44.
- Higgins TL, Kramer AA, Nathanson BH, Copes W, Stark M, Teres D. Prospective validation of the intensive care unit admission Mortality Probability Model (MPM0-III). Crit Care Med 2009; 37: 1619-23.
- Castella X, Artigas A, Bion J, Kari A. A comparison of severity of illness scoring systems for intensive care unit patients: results of a multicenter, multinational study. The European/North American Severity Study Group. Crit Care Med 1995; 23: 1327-35.
- Poole D, Rossi C, Latronico N, Rossi G, Finazzi S, Bertolini G. Comparison between SAPS II and SAPS 3 in predicting hospital mortality in a cohort of 103 Italian ICUs. Is new always better? Intensive Care Med 2012; 38: 1280-8.
- MD CALC. APACHE II Score-Estimates ICU mortality. Available online: https://www.mdcalc.com/calc/1868/apache-ii-score (accessed Feb 2022)
- Intensve Cate Network. Available online: https://intensivecarenetwork.com (accessed Feb 2022)
- ClinCalc. SAPS II Calculator Simplified Acute Physiology Score (SAPS) II calculator to predict hospital mortality. Available online: https://clincalc.com/IcuMortality/SAPSII.aspx (accessed Feb 2022)
- UpToDate. Calculator: Mortality Probability Admission Model (MPM0-III) for critical illness in adults. Available online: https://www.uptodate.com/contents/calculator-mortality-probability-admission-model-mpm0-iii-for-critical-illness-in-adults (accessed Feb 2022
- Keegan MT, Gajic O, Afessa B. Severity of illness scoring systems in the intensive care unit. Crit Care Med 2011; 39: 163-9.
- Freire P, Romãozinho JM, Amaro P, Ferreira M, Sofia C. Prognostic scores in a gastroenterology intensive care unit. Rev Esp Enferm Dig 2010; 102: 596-601.
- Akavipat P, Thinkhamrop J, Thinkhamrop B, Sriraj W. Acute Physİology And Chronİc Health Evaluatİon (APACHE) II Score-the clinical predictor in neurosurgıial intensive care unit. Acta Clin Croat 2019; 58: 50-6.
- Godinjak A, Iglica A, Rama A, et al. Predictive value of SAPS II and APACHE II scoring systems for patient outcome in a medical intensive care unit. Acta Med Acad 2016; 45: 97-103.
- Gürsoy G, Gürsoy C, Kuşcu Y, Gümüş Demirbilek S. APACHE II or INCNS to predict mortality in traumatic brain injury: A retrospective cohort study. Ulus Travma Acil Cerrahi Derg 2020; 26: 893-8
- Gai X, Wang Y, Gao D, Ma J, Zhang C, Wang Q. Risk factors for the prognosis of patients with sepsis in intensive care units. PLoS One 2022 6;17: e0273377.
- Liu C, Suo S, Luo L, Chen X, Ling C, Cao S. SOFA Score in relation to Sepsis: Clinical Implications in Diagnosis, Treatment, and Prognostic Assessment. Comput Math Methods Med 2022 ; 2022: 7870434.
- Argyriou G, Vrettou CS, Filippatos G, Sainis G, Nanas S, Routsi C. Comparative evaluation of Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scoring systems in patients admitted to the cardiac intensive care unit. J Crit Care 2015; 30: 752-7
- Vincent JL, Sakr Y, Sprung CL, et al. Sepsis Occurrence in Acutely Ill Patients Investigators. Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 2006 ; 34: 344-53.
Details
| Primary Language | English |
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| Subjects | Health Care Administration |
| Journal Section | Original Article |
| Authors | |
| Publication Date | October 25, 2022 |
| Published in Issue | Year 2022 Volume: 5 Issue: 6 |
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