Comparison of Acute Physiology and Chronic Health Evaluation (APACHE) II score with organ failure scores to predict hospital mortality

• Published in: Anaesthesia 2007-05, Vol.62 (5), p.466-473
• Main Authors: Ho, K. M., Lee, K. Y., Williams, T., Finn, J., Knuiman, M., Webb, S. A. R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anatomy & physiology; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; APACHE; Biological and medical sciences; Calibration; Comparative analysis; Critical Illness - mortality; Female; Hospital Mortality; Humans; Intensive care; Intensive Care Units; Male; Medical sciences; Middle Aged; Mortality; Multiple Organ Failure - diagnosis; Multiple Organ Failure - mortality; Predictions; Prognosis; ROC Curve; Severity of Illness Index; Standard scores; Western Australia - epidemiology
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2007.04999.x

Summary This study compared the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II score with two organ failure scores in predicting hospital mortality of critically ill patients. A total of 1311 consecutive adult patients in a tertiary 22‐bed multidisciplinary intensive care unit (ICU) in Western Australia were considered. The APACHE II score had a better calibration and discrimination than the Max Sequential Organ Failure Score (Max SOFA) (area under receiver operating characteristic (ROC) curve 0.858 vs 0.829), Admission SOFA (area under ROC 0.858 vs 0.791), and the first day or cumulative 5‐day Royal Perth Hospital Intensive Care Unit (RPHICU) organ failure score (area under ROC 0.858 vs 0.822 and 0.819, respectively) in predicting hospital mortality. The APACHE II score predicted hospital mortality of critically ill patients better than the SOFA and RPHICU organ failure scores in our ICU.