Comparison of Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation III Scoring Systems in Prediction of Mortality in Non-traumatic Patients Admitted to the Intensive Care Unit

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Due to the insufficiency of resources in the intensive care unit (ICU), different ranking and evaluation systems are presented in order to predict the prognosis and mortality rates of patients in ICU. Two of these evaluation systems are Acute Physiology and Chronic Health Evaluation (APACHE) and Sequential Organ Failure Assessment (SOFA). So far, these two systems have not been compared. So we aimed to compare SOFA and APACHE III.Methods: This cross-sectional study was performed in 2016 in Alzahra hospital, Isfahan, Iran. We studied a total number of 100 non-traumatic ICU patients, and APACHE and SOFA scores were evaluated for each of them. Data were then collected and analyzed using SPSS software.Findings: Of the total 100 patients, 21% of them died. Both APACHE III and SOFA had an accuracy rate of 95.20% for those patients who were going to die. On the other hand, SOFA system had an accuracy rate of 26.08% for prediction of those patients who were going to live, which was 36.36% for APACHE III in same patients (P < 0.001).Conclusion: Our results indicate that APACHE III and SOFA have the same value in prediction of mortality rate in patients admitted to ICU; but for negative predictive values, APACHE III has a better preference.

Keywords

References

  1. Herridge MS. Prognostication and intensive care unit outcome: The evolving role of scoring systems. Clin Chest Med 2003; 24(4): 751-62.
  2. Bouch DC, Thompson JP. Severity scoring systems in the critically ill. Continuing Education in Anaesthesia Critical Care and Pain 2008; 8(5): 181-5.
  3. Lechiancole A, Sponga S, Isola M, Vendramin I, Maiani M, Livi U. Heart transplantation in patients supported by ECMO: Is the APACHE IV score a predictor of survival? Artif Organs 2018; 42(6): 670-3.
  4. Boricic R, Smolovic B, Lukic M. The value of APACHE II in predicting severity, mortality and duration of hospital treatment in the Montenegrin population with acute pancreatitisexperience of the clinical center of Montenegro. Pancreatology 2018; 18(4, Supplement): S13-S14.
  5. Pattison R, Shakespeare A, Tanner SB, Zolfaghari K, Ettlinger J, Jimenez E, et al. Superiority of APACHE IV versus SOFA & qSOFA in predicting mortality in patients with sepsis admitted to the ICU. B43. Critical care: I Still Haven't Found What I'm Looking for - Identifying and Managing Sepsis. Am J Respir Crit Care Med 2018; 197: A3303.
  6. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991; 100(6): 1619-36.
  7. Allard J, Cotin S, Faure F, Bensoussan PJ, Poyer F, Duriez C, et al. SOFA--an open source framework for medical simulation. Stud Health Technol Inform 2007; 125: 13-8.
  8. Raith EP, Udy AA, Bailey M, McGloughlin S, MacIsaac C, Bellomo R, et al. Prognostic accuracy of the SOFA Score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA 2017; 317(3): 290-300.
  9. Necchi A, Mariani L, Raggi D, Giannatempo P, Colecchia M, Calareso G, et al. Abstract CT102: APACHE: An open label, randomized, phase II study of Durvalumab (Durva), alone or in combination with Tremelimumab (Treme), in patients (pts) with advanced germ cell tumors (GCT): Results at the end of first stage. Cancer Res 2018; 78(13 Supplement): CT102.
  10. Chang WA, Tsai JR, Tsai MJ, Kuo CY, Sheu CC. SOFA Score Is a Good Predictor of ICU Mortality in Severe Dengue. A55. Critical Care: SIRS, QSOFA, SEPSIS - What's in a Name? Am J Respir Crit Care Med 2017; 195: A1903.
  11. Ho KM, Lee KY, Williams T, Finn J, Knuiman M, Webb SA. Comparison of Acute Physiology and Chronic Health Evaluation (APACHE) II score with organ failure scores to predict hospital mortality. Anaesthesia 2007; 62(5): 466-73.
  12. Kaymak C, Sencan I, Izdes S, Sari A, Yagmurdur H, Karadas D, et al. Mortality of adult intensive care units in Turkey using the APACHE II and SOFA systems (outcome assessment in Turkish intensive care units). Arch Med Sci 2018; 14(3): 510-5.
  13. Niewinski G, Starczewska M, Kanski A. Prognostic scoring systems for mortality in intensive care units--the APACHE model. Anaesthesiol Intensive Ther 2014; 46(1): 46-9.
  14. Rahimzadeh P, Taghipur Anvari Z, Hassani V. Estimation of mortality rate of patients in surgical intensive care unit of Hazrat-Rasul hospital of Tehran using the APACHE II standard disease severity scoring system. Hakim Health Sys Res 2008; 11(1): 22-8. [In Persian].
  15. Gosling P, Czyz J, Nightingale P, Manji M. Microalbuminuria in the intensive care unit: Clinical correlates and association with outcomes in 431 patients. Crit Care Med 2006; 34(8): 2158-66.
  16. Peres BD, Melot C, Lopes FF, Nguyen B, V, Vincent JL. The Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) score in outcome prediction. Intensive Care Med 2002; 28(11): 1619-24.
  17. Mahshidfar B, Davoudi L, Farsi D, Abbasi S, Hafezimoghadam P, Rezai M et al . The relationship between APACHE-II scoring system and mortality of patients admitted to the emergency intensive care unit (EICU) and comparing it to those of the patients admitted to the medical and surgical intensive care units (MICU and SICU). Razi J Med Sci 2016; 23(142): 26-33. [In Persian].
  18. Needleman J, Buerhaus P, Pankratz VS, Leibson CL, Stevens SR, Harris M. Nurse staffing and inpatient hospital mortality. N Engl J Med 2011; 364: 1037-45.
  19. Minne L, Abu-Hanna A, de JE. Evaluation of SOFA-based models for predicting mortality in the ICU: A systematic review. Crit Care 2008; 12(6): R161.
Journal of Isfahan Medical School
Volume 36, Issue 496 - Serial Number 496
July and August 2018
Pages 1093-1099

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History

  • Receive Date: 12 August 2018
  • Revise Date: 07 May 2024
  • Accept Date: 06 April 2022

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