Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit

Détails

ID Serval
serval:BIB_101046B384F6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit
Périodique
Critical Care Medicine
Auteur(s)
Berger  M. M., Marazzi  A., Freeman  J., Chiolero  R.
ISSN
0090-3493 (Print)
Statut éditorial
Publié
Date de publication
12/1992
Peer-reviewed
Oui
Volume
20
Numéro
12
Pages
1681-7
Langue
anglais
Notes
Clinical Trial
Comparative Study
Journal Article --- Old month value: Dec
Résumé
OBJECTIVES: To determine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in a Swiss ICU, and to evaluate its utility in evaluating data from 2 yrs of consecutive admissions to show that the predictability of outcome is similar to that predictability observed by Knaus et al. in 1985 (in 5,815 patients), with the provision that large numbers of patients are studied. DESIGN: Prospective clinical trial over 2 yrs, with statistical analysis of the Swiss patients, and between the Swiss patients and the patients studied by Knaus et al. Receiver operating characteristic curves were calculated. SETTING: Surgical ICU in a Swiss university hospital. PATIENTS: A total of 2,061 consecutive patients admitted to the surgical ICU who were classified as postoperative (elective or emergency) and nonoperative. Hospital mortality rate was considered. RESULTS: Patients were 53 +/- 16 yrs of age. Mean APACHE II score was 10.5 +/- 7.0. The mean APACHE II score was significantly (p < .001) lower in the 1,813 survivors (9.0 +/- 5.2) than in the 248 nonsurvivors (21.5 +/- 8.5). The mortality rate was higher among the Swiss patients when compared with the patients studied by Knaus et al. who had postoperative scores of 20 to 29 and nonoperative scores of > 24. The distribution of the scores and mortality rates were stable during the two study periods, as were the differences in mortality rates between the Swiss population and that population studied by Knaus et al. Sensitivity and specificity of the scores were highest in the emergency surgery group (87% and 78%), and lowest in the elective surgery group (76% and 73%). The APACHE equation underestimated the risk of death. CONCLUSIONS: The APACHE II score, because of its consistency over time and the stability of the mortality rates, can be used in our surgical ICU without modification. The calculated risk of death gives no additional information.
Mots-clé
Adolescent Adult Aged Aged, 80 and over Child Female Humans *Intensive Care Units Male Middle Aged Outcome Assessment (Health Care) *Postoperative Care Prospective Studies ROC Curve Sensitivity and Specificity *Severity of Illness Index Surgical Procedures, Operative/mortality Switzerland
Pubmed
Web of science
Création de la notice
24/01/2008 16:52
Dernière modification de la notice
20/08/2019 12:36
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