Department of Anaesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia, 14 Medykow Street, 40752 Katowice, Poland.
Int J Environ Res Public Health. 2019 Sep 13;16(18):3394. doi: 10.3390/ijerph16183394.
The Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scales are scoring systems used in intensive care units (ICUs) worldwide. We aimed to investigate their usefulness in predicting short- and long-term prognosis in the local ICU.
This single-center observational study covered 905 patients admitted from 1 January 2015 to 31 December 2017 to a tertiary mixed ICU. SAPS II, APACHE II, and SOFA scores were calculated based on the worst values from the first 24 h post-admission. Patients were divided into surgical (SP) and nonsurgical (NSP) subjects. Unadjusted ICU and post-ICU discharge mortality rates were considered the outcomes.
Baseline SAPS II, APACHE II, and SOFA scores were 41.1 ± 20.34, 14.07 ± 8.73, and 6.33 ± 4.12 points, respectively. All scores were significantly lower among SP compared to NSP ( < 0.05). ICU mortality reached 35.4% and was significantly lower for SP (25.3%) than NSP (57.9%) ( < 0.001). The areas under the receiver-operating characteristic (ROC) curves were 0.826, 0.836, and 0.788 for SAPS II, APACHE II, and SOFA scales, respectively, for predicting ICU prognosis, and 0.708, 0.709, and 0.661 for SAPS II, APACHE II, and SOFA, respectively, for post-ICU prognosis.
Although APACHE II and SAPS II are good predictors of ICU mortality, they failed to predict survival after discharge. Surgical patients had a better prognosis than medical ICU patients.
简化急性生理学评分（SAPS） II、急性生理学和慢性健康评估（APACHE） II 和序贯器官衰竭评估（SOFA）量表是全球重症监护病房（ICU）中使用的评分系统。我们旨在研究它们在预测当地 ICU 短期和长期预后方面的有用性。
这项单中心观察性研究涵盖了 2015 年 1 月 1 日至 2017 年 12 月 31 日期间入住一家三级混合 ICU 的 905 名患者。SAPS II、APACHE II 和 SOFA 评分根据入院后 24 小时内的最差值计算。患者分为外科（SP）和非外科（NSP）患者。未调整的 ICU 和 ICU 后出院死亡率被认为是结局。
基线 SAPS II、APACHE II 和 SOFA 评分分别为 41.1 ± 20.34、14.07 ± 8.73 和 6.33 ± 4.12 分。与 NSP 相比，SP 的所有评分均显著较低（<0.05）。ICU 死亡率达到 35.4%，SP（25.3%）显著低于 NSP（57.9%）（<0.001）。SAPS II、APACHE II 和 SOFA 量表预测 ICU 预后的受试者工作特征（ROC）曲线下面积分别为 0.826、0.836 和 0.788，预测 ICU 后预后的 AUC 分别为 0.708、0.709 和 0.661。
尽管 APACHE II 和 SAPS II 是 ICU 死亡率的良好预测指标，但它们未能预测出院后的生存率。外科患者的预后优于内科 ICU 患者。
