Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Nov;9(11):907-910.
doi: 10.14740/jocmr3083w. Epub 2017 Oct 2.

Predicting Mortality of Patients With Sepsis: A Comparison of APACHE II and APACHE III Scoring Systems

Farid Sadaka  1 , Cheikh EthmaneAbouElMaali  1 , Margaret A Cytron  1 , Kimberly Fowler  1 , Victoria M Javaux  1 , Jacklyn O'Brien  1
Affiliations

Predicting Mortality of Patients With Sepsis: A Comparison of APACHE II and APACHE III Scoring Systems

Farid Sadaka et al. J Clin Med Res. 2017 Nov.

Abstract

Background: Acute Physiology, Age and Chronic Health Evaluation (APACHE) II and III scores were developed in 1985 and 1991, respectively, and are used mainly for critically ill patients of all disease categories admitted to the intensive care unit (ICU). They differ in how chronic health status is assessed, in the number of physiologic variables included (12 vs. 17), and in the total score. These two scoring systems have not been compared in predicting hospital mortality in patients with sepsis.

Methods: We retrospectively identified all septic patients admitted to our 54-bed medical-surgical ICU between June 2009 and February 2014 using the APACHE outcomes database. We calculated correlation coefficients for APACHE II and APACHE III scores in predicting hospital mortality. Receiver-operating characteristic (ROC) curves were also used to assess the mortality predictions.

Results: We identified a total of 2,054 septic patients. Average APACHE II score was 19 ± 7, and average APACHE III score was 68 ± 28. ICU mortality was 11.8% and hospital mortality was 18.3%. Both APACHE II (r = 0.41) and APACHE III scores (r = 0.44) had good correlations with hospital mortality. There was no statistically significant difference between the two correlations (P = 0.1). ROC area under the curve (AUC) was 0.80 (95% confidence interval (CI): 0.78 - 0.82) for APACHE II, and 0.83 (95% CI: 0.81 - 0.85) for APACHE III, suggesting that both scores have very good discriminative powers for predicting hospital mortality.

Conclusions: This study shows that both APACHE II and APACHE III scores in septic patients were very strong predictors of hospital mortality. APACHE II was as good as APACHE III in predicting hospital mortality in septic patients.

Keywords: APACHE; Acute physiologic and chronic health evaluation; Epidemiology; Mortality; Outcome; Sepsis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Receiver operating characteristic curves for APACHE II score and APACHE III score for prediction of hospital mortality.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, Kumar A. et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45(3):486–552. doi: 10.1097/CCM.0000000000002255. - DOI - PubMed
    1. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546–1554. doi: 10.1056/NEJMoa022139. - DOI - PubMed
    1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303–1310. doi: 10.1097/00003246-200107000-00002. - DOI - PubMed
    1. Annane D, Aegerter P, Jars-Guincestre MC, Guidet B, Network CU-R. Current epidemiology of septic shock: the CUB-Rea Network. Am J Respir Crit Care Med. 2003;168(2):165–172. doi: 10.1164/rccm.2201087. - DOI - PubMed
    1. Pittet D, Rangel-Frausto S, Li N, Tarara D, Costigan M, Rempe L, Jebson P. et al. Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Med. 1995;21(4):302–309. doi: 10.1007/BF01705408. - DOI - PubMed

LinkOut - more resources