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. 2019 Mar;58(1):50-56.
doi: 10.20471/acc.2019.58.01.07.

ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION (APACHE) II SCORE - THE CLINICAL PREDICTOR IN NEUROSURGICAL INTENSIVE CARE UNIT

Phuping Akavipat  1 , Jadsada Thinkhamrop  1 , Bandit Thinkhamrop  1 , Wimonrat Sriraj  1
Affiliations

ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION (APACHE) II SCORE - THE CLINICAL PREDICTOR IN NEUROSURGICAL INTENSIVE CARE UNIT

Phuping Akavipat et al. Acta Clin Croat. 2019 Mar.

Abstract

The APACHE II scoring system is approved for its benchmarking and mortality predictions, but there are only a few articles published to demonstrate it in neurosurgical patients. Therefore, this study was performed to acknowledge this score and its predictive performance to hospital mortality in a tertiary referral neurosurgical intensive care unit (ICU). All patients admitted to the Neurosurgical ICU from February 1 to July 31, 2011 were recruited. The parameters indicated in APACHE II score were collected. The adjusted predicted risk of death was calculated and compared with the death rate observed. Descriptive statistics including the receiver operating characteristic curve (ROC) was performed. The results showed that 276 patients were admitted during the mentioned period. The APACHE II score was 16.56 (95% CI, 15.84-17.29) and 19.08 (95% CI, 15.40-22.76) in survivors and non-survivors, while the adjusted predicted death rates were 13.39% (95% CI, 11.83-14.95) and 17.49% (95% CI, 9.81-25.17), respectively. The observed mortality was only 4.35%. The area under the ROC of APACHE II score to the hospital mortality was 0.62 (95% CI, 0.44-0.79). In conclusion, not only the APACHE II score in neurosurgical patients indicated low severity, but its performance to predict hospital mortality was also inferior. Additional studies of predicting mortality among these critical patients should be undertaken.

Keywords: APACHE; Hospital mortality; Intensive care units; Length of stay; Severity of illness index.

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Figures

Fig. 1
Fig. 1
Summary variables and calculation methods for Acute Physiology and Chronic Health Evaluation (APACHE) II score.
Fig. 2
Fig. 2
Hospital mortality categorized by Acute Physiology and Chronic Health Evaluation (APACHE) II score.
Fig. 3
Fig. 3
The receiver operating characteristic curve of the Acute Physiology and Chronic Health Evaluation (APACHE) II score.
See this image and copyright information in PMC

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References

    1. Kiphuth IC, Schellinger PD, Kohrmann M, Bardutzky J, Lucking H, Kloska S, et al. Predictors for good functional outcome after neurocritical care. Crit Care. 2010;14:R136. 10.1186/cc9192 - DOI - PMC - PubMed
    1. Rodríguez Villar S, Barrientos Yuste RM. Long-term admission to the intensive care unit: a cost-benefit analysis. Rev Esp Anestesiol Reanim. 2014;61:489–96. 10.1016/j.redar.2014.02.008 - DOI - PubMed
    1. Park SK, Chun HJ, Kim DW, Im TH, Hong HJ, Yi HJ. Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in predicting hospital mortality of neurosurgical intensive care unit patients. J Korean Med Sci. 2009;24:420–6. 10.3346/jkms.2009.24.3.420 - DOI - PMC - PubMed
    1. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818–29. 10.1097/00003246-198510000-00009 - DOI - PubMed
    1. Moon BH, Park SK, Jang DK, Jang KS, Kim JT, Han YM. Use of APACHE II and SAPS II to predict mortality for hemorrhagic and ischemic stroke patients. J Clin Neurosci. 2015;22:111–5. 10.1016/j.jocn.2014.05.031 - DOI - PubMed

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