Effectiveness of Scoring in Outcome Prediction of Elderly Patients in Intensive Care Units (original) (raw)
Related papers
Validation of a prognostic score for mortality in elderly patients admitted to Intensive Care Unit
Indian Journal of Critical Care Medicine, 2016
Context: The performance of a prognostic score must be evaluated prior to being used. The aim of the present study was to evaluate the predictive ability of hospital mortality of Simplified Acute Physiology Score 3 (SAPS 3) score in elderly patients admitted to Intensive Care Units (ICUs). Aims: The aim of the present study was to evaluate the SAPS 3 score predictive ability of hospital mortality in elderly patients admitted to ICU. Settings and Design: This study was conducted as a prospective cohort, in two mixed ICUs. Patients and Methods: Two hundred and eleven elderly patients were included. Interventions: None. We compared the predictive accuracy of SAPS 3 measured at the first hour at ICU and Acute Physiology and Chronic Health Evaluation II (APACHE II) measured with the worst values in the first 24 h at ICU. The patients were followed until hospital discharge. Statistical Analysis Used: Evaluation of discrimination through area under curve receiver operating characteristic (aROC) and calibration by Hosmer-Lemeshow (HL) test. Results: The median age was 68 years. The hospital mortality rate was 35.54%. The mean value of SAPS 3 was 62.54 ± 12.51 and APACHE II was 17.46 ± 6.77. The mortality predicted by APACHE II was 24.98 ± 19.96 and for standard SAPS 3 equation 41.18 ± 22.34. The discrimination for SAPS 3 model was aROC = 0.68 (0.62-0.75) and to APACHE II aROC = 0.70 (0.63-0.78). Calibration: APACHE II with HL 10.127 P = 0.26, and standard SAPS 3 equation HL 7.204 P = 0.51. Conclusions: In this study, the prognostic model of SAPS 3 was not found to be accurate in predicting mortality in geriatric patients requiring ICU admission.
Romanian Journal of Anaesthesia and Intensive Care, 2019
Background and Aims: In this study, we aimed to evaluate whether the age or the APACHE-II score was a better predictor of mortality in each group. The secondary objective was to investigate the factors affecting the mortality in each individual age group. Methods: We designed this retrospective study between 2016-2017. Age groups were classified into 3 classes: Patients < 60 years were Group 1, patients between 60-70 years were Group 2, and patients > 70 years were Group 3. We recorded patients’ age, ICU indication, demographic data, APACHE-II, ASA, length of hospital stays and mortality. Results: We analysed 150 patients and reported mortality for 58 patients (38.7%). We did not detect any association between age and mortality for all groups. ASA, length of ICU stays and predicted mortality rate, were significantly higher for exitus patients (p < 0.001). The ROC curve for the APACHE-II score, with a cut-off point of 23, demonstrated 74.14% sensitivity, 60.87% specificity, ...
Prediction of Outcome in ICU Patients Using SAPS II Scoring-A Prospective Study
Since 1981, several severity scores have been proposed for ICU patients. The first ones were acute physiology and chronic health evaluation(APACHE, APACHEII),Simplified acute physiology score (SAPS); later, mortality probability model(MPM) and APACHE III were introduced. The SAPS II scoring system, have been used as a method for converting the score to a probability of hospital mortality.The present prospective study is designed to predict the ICU outcome in medical ICU patients. Objective of the Study: To predict the mortality and morbidity of the patients admitted in ICU for various emergencies using SAPS II scoring system and correlate it with the outcome of the patient on discharge. Materials and Methods: The study prospective type, data was obtained from the patients admitted to ICU ,SAPS II scoring was given and were followed up till they got discharged to assess the outcome .Results:45 patients were studied the total mortality was 26.6%. The SAPS II Scores of the patients and the number of deaths in the different groups are given in table below. The chi-square value was 23.04, df= 6with a p + 0.0007 and this study is well within the p value of 0.05, hence it is significant which means the higher the score the more is the risk of morbidity and mortality, when score is >50 there is increased risk of morbidity and mortality, when score is >50 there is increased risk of mortality. Conclusion:The present study imposes on the following conclusions -SAPS II scoring is useful in predicting the ICU outcome of patients admitted in the ICU even when the primary diagnosis is not specified.
Asian Journal of Nursing Education and Research
Background: Prognostication of critically ill patients is an integral part of the quality of care in ICU. The use of scoring system such as Acute Physiology and Chronic Health Evaluation (APACHE) to predict risk of mortality and evaluating outcome in critically ill patients is important in modern evidence-based medicine. the aim of the study was to compare the APACHE II and APACHE IV in predicting the mortality of patients intensive care unit. Methods: A prospective descriptive was among 100 adult patients admitted irrespective of diagnosis and managed for >24hours in the 25 bedded multidisciplinary ICU of a tertiary care hospital. The APACHE II and APACHE IV scores were calculated using the online calculators, based on the worst values in the first 24hours of admission. All the study participants were followed up, to determine the observed mortality rates and length of stay of ICU which were compared with predicted mortality rates obtained from both the APACHE II and APACHE IV s...
2020
Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed.Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was ...
Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU
Journal of the American Geriatrics Society
On behalf of the VIP1 Study Group # OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN: Prospective cohort study. SETTING: A total of 306 ICUs from 24 European countries. PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male). MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis,
International Journal of Research in Medical Sciences, 2019
Background: The prognostication of critically ill patients, in a systematic way, based on definite objective data is an integral part of the quality of care in Intensive Care Unit (ICU). Acute physiology and chronic health evaluation (APACHE) scoring systems provide an objective means of mortality prediction in Intensive Care Unit (ICU). The aims of this study were to compare the performance of APACHE II and APACHE IV in predicting mortality in our intensive care unit (ICU).Methods: A prospective observational study was conducted in a 13 bedded intensive care unit (ICU) of a tertiary level teaching hospital. All the patients above the age of 12 years, irrespective of diagnosis managed in ICU for >24hours were enrolled. APACHE II and APACHE IV scores were calculated based on the worst values in the first 24hours of admission. All enrolled patients were followed up, and outcome was recorded as survivors or non survivors. Observed mortality rates were compared with predicted mortali...
Acta Medica Academica
Objective. The aim is to determine SAPS II and APACHE II scores in medical intensive care unit (MICU) patients, to compare them for prediction of patient outcome, and to compare with actual hospital mortality rates for different subgroups of patients. Methods. One hundred and seventy-four patients were included in this analysis over a oneyear period in the MICU, Clinical Center, University of Sarajevo. The following patient data were obtained: demographics, admission diagnosis, SAPS II, APACHE II scores and final outcome. Results. Out of 174 patients, 70 patients (40.2%) died. Mean SAPS II and APACHE II scores in all patients were 48.4±17.0 and 21.6±10.3 respectively, and they were significantly different between survivors and non-survivors. SAPS II >50.5 and APACHE II >27.5 can predict the risk of mortality in these patients. There was no statistically significant difference in the clinical values of SAPS II vs APACHE II (p=0.501). A statistically significant positive correlation was established between the values of SAPS II and APACHE II (r=0.708; p=0.001). Patients with an admission diagnosis of sepsis/septic shock had the highest values of both SAPS II and APACHE II scores, and also the highest hospital mortality rate of 55.1%. Conclusion. Both APACHE II and SAPS II had an excellent ability to discriminate between survivors and non-survivors. There was no significant difference in the clinical values of SAPS II and APACHE II. A positive correlation was established between them. Sepsis/septic shock patients had the highest predicted and observed hospital mortality rate.