Mumtaz Hassan, Ejaz Muhammad K, Tayyab Muhammad, Vohra Laiba I, Sapkota Shova, Hasan Mohammad, Saqib Muhammad
Health Services Academy, Islamabad.
Gujranwala Medical College, Gujranwala, Punjab.
Ann Med Surg (Lond). 2023 Mar 24;85(3):416-421. doi: 10.1097/MS9.0000000000000264. eCollection 2023 Mar.
Predictive scoring systems are tools that assess the magnitude of a patient's illness and forecast disease prognosis, usually in the form of mortality, in the ICU. We aimed to determine the mortality rate among patients admitted to ICU using the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system correlating with lengths of stay in the ICU.
A cohort study using team approach to care was conducted from July 2021 through July 2022 at KRL Hospital. Five hundred fifty-two patients aged 18-40 years, admitted for medical or surgical reasons (other than cardiac) who stayed in the ICU for more than 24 h were included. The APACHE II score was determined using 12 physiological variables at the end of the first 24 h of ICU admission. Data were analyzed using IBM Corp. released in 2015 (IBM SPSS Statistics for Windows, Version 23.0, Armonk, New York).
The average age of study participants was 36.34±2.77, ranging from 18 to 40 years. Three hundred fifteen participants were males and 237 were females. Patients were categorized into four separate groups as per their respective APACHE II scores. Patients with an APACHE II score of 31-40 were assigned to group 1. Patients with an APACHE II score of 21-30 were assigned to group 2. Patients with an APACHE II score of 11-20 were assigned to group 3. Lastly, patients with an APACHE II score of 3-10 were assigned to group 4. All patients in group 1 and group 2 died and none survived. Groups 1 and 2 contained a sum of 228 patients. A total of 123 patients were assigned to group 3, out of which 88 patients (71.54%) survived and 35 patients (28.45%) died. From these observations, it is evident that a higher APACHE II score is correlated with increased mortality.
APACHE II scoring serves as an early warning indication of death and prompts clinicians to upgrade their treatment protocol. This makes it a useful tool for the clinical prediction of ICU mortality.
预测评分系统是评估患者疾病严重程度并预测疾病预后的工具，通常以重症监护病房（ICU）死亡率的形式呈现。我们旨在使用急性生理与慢性健康状况评估II（APACHE II）评分系统确定入住ICU患者的死亡率，并将其与在ICU的住院时长相关联。
2021年7月至2022年7月在KRL医院开展了一项采用团队护理方法的队列研究。纳入552例年龄在18至40岁之间、因医疗或手术原因（非心脏原因）入住ICU且住院时间超过24小时的患者。在入住ICU的前24小时结束时，使用12项生理变量确定APACHE II评分。数据使用IBM公司2015年发布的软件（IBM SPSS Statistics for Windows，版本23.0，纽约州阿蒙克）进行分析。
研究参与者的平均年龄为36.34±2.77岁，年龄范围为18至40岁。315名参与者为男性，237名参与者为女性。根据各自的APACHE II评分，将患者分为四个不同的组。APACHE II评分为31 - 40的患者被分配到第1组。APACHE II评分为21 - 30的患者被分配到第2组。APACHE II评分为11 - 20的患者被分配到第3组。最后，APACHE II评分为3 - 10的患者被分配到第4组。第1组和第2组的所有患者均死亡，无一存活。第1组和第2组共有228例患者。共有123例患者被分配到第3组，其中88例患者（71.54%）存活，35例患者（28.45%）死亡。从这些观察结果可以明显看出，较高的APACHE II评分与死亡率增加相关。
APACHE II评分可作为死亡的早期预警指标，并促使临床医生升级治疗方案。这使其成为ICU死亡率临床预测的有用工具。
