Milić Morena, Goranović Tatjana, Holjevac Jadranka Katancić
Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, University Hospital "Dubrava", Zagreb, Croatia.
Coll Antropol. 2009 Sep;33(3):831-5.
The aim of this study was to evaluate the usefulness of using Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sequential Organ Failure Assessment (SOFA) score as the predictors of length of stay (LOS) in various surgical intensive care units (ICUs) and to test the hypothesis that the significance of scoring for predicting LOS is greater in specialized surgical ICUs. We scored patients in a non-specialized general surgical ICU (n = 328) and in a specialized cardiosurgical ICU (n = 158) consecutively on admission (APACHE II-1st day; SOFA-1st day) and on third day of stay (APACHE II-3rd day; SOFA-3rd day) in a 4-month period. LOS and APACHE II/SOFA scores were significantly correlated both on admission and on third day of stay in the general surgical ICU (APACHE II-1st day r = 0.289; SOFA-1st day r = 0.306; APACHE II-3rd day r = 0.728; SOFA-3rd day r = 0.725). LOS and APACHE II on admission were not significantly correlated in the cardiosurgical ICU (APACHE II-1st day r = 0.092), while SOFA on admission and APACHE II and SOFA on third day were significantly correlated (SOFA-1st day r = 0.258; APACHE II-3rd day r = 0.716; SOFA-3rd day r = 0.719). Usefulness of scoring for predicting LOS in ICU varied between different surgical ICUs. Contrary to our hypothesis, scoring had greater value for predicting LOS in the non-specialized general surgical ICU. APACHE II score on admission had no value for predicting LOS in the cardiosurgical ICU.
本研究的目的是评估使用急性生理与慢性健康状况评估(APACHE)II评分和序贯器官衰竭评估(SOFA)评分作为各外科重症监护病房(ICU)住院时间(LOS)预测指标的有效性,并检验以下假设:在专科外科ICU中,评分对预测LOS的意义更大。在4个月的时间里,我们连续对非专科普通外科ICU(n = 328)和专科心脏外科ICU(n = 158)的患者在入院时(APACHE II第1天;SOFA第1天)以及住院第3天(APACHE II第3天;SOFA第3天)进行评分。在普通外科ICU,入院时和住院第3天的LOS与APACHE II/SOFA评分均显著相关(APACHE II第1天r = 0.289;SOFA第1天r = 0.306;APACHE II第3天r = 0.728;SOFA第3天r = 0.725)。在心脏外科ICU,入院时LOS与APACHE II无显著相关性(APACHE II第1天r = 0.092),而入院时SOFA以及第3天的APACHE II和SOFA均显著相关(SOFA第1天r = 0.258;APACHE II第3天r = 0.716;SOFA第3天r = 0.719)。不同外科ICU中评分对预测LOS的有效性各不相同。与我们的假设相反,在非专科普通外科ICU中,评分对预测LOS的价值更大。入院时APACHE II评分对心脏外科ICU的LOS预测无价值。