Acute Physiology And Chronic Health Evaluation (Apache) II Scoring system as mortality prediction for Intensive Care Unit patients

· Critical Care

Diah Handayani, Nirwan Arief, Boedi Swidarmoko, Pudjo Astowo, Muhammad Sopiyudin Dahlan

Background: Realizing the utility of scoring systems in mortality prediction of critically ill patients admitted to intensive care unit (ICU), studies worldwide have expressed a need to validate the Acute Physiology and Chronic Health Evaluation (APACHE) II score for database of respective centers. The present study was undertaken to evaluate the performance of APACHE II score in prediction of mortality risk, as well as in determination of model validity in critically ill patients with respiratory problems and post thoracic surgery that were hospitalized in ICU of Persahabatan Hospital.
Methods: A cohort study of the patients were hospitalized in ICU Persahabatan hospital with respiratory diseases were evaluated and scored of APACHE II and the outcome on July 2003 – June 2006.
Results: Mean APACHE II score was 13.4±9.9 (0 to 49) there were 171 (72.8%) survivors and 64 (27.2%) non-survivors, whose mean APACHE II score being respectively 9±0,4 and 25±1.3 were significantly different (p=0.000). The cut off point of APACHE II score was 16 with sensitivity 79.9% and specifi city 88%. This score also showed a good discrimination (AUC 0.906) but poor calibration (p<0.5).
Conclusion: The APACHE II scoring system showed a good discrimination and the predicted mortality correlated with observed mortality. (J Respir Indo. 2014; 34: 36-45)

Key words: The APACHE II, cut off point, mortality prediction, ICU.

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