Ludwigs U, Hulting J
Medical Intensive Care Unit, Department of Medicine, Södersjukhuset, Stockholm, Sweden.
Crit Care Med. 1995 May;23(5):854-9. doi: 10.1097/00003246-199505000-00013.
To study the usefulness of the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system for prognostication of inhospital mortality in acute myocardial infarction.
A prospective validation study.
A medical intensive care unit (ICU) at a university hospital.
Over a 3-yr period, 2,007 admissions of 1,714 patients with acute myocardial infarction were studied. In readmissions to the medical ICU during the same hospital stay, only the first admission was studied.
Mean age of the patients was 72 +/- 10 yrs. The medical ICU mortality rate was 13% and total hospital mortality rate was 16%. Mean APACHE II score was 11.6 +/- 6.5. There was a close correlation between observed and predicted mortality rates in classes of patients with various APACHE II scores. Observed mortality in patients with scores of 20 to 24 was higher than the predicted mortality (p < .03). In this subgroup, 25% of the patients had a length of stay in the medical ICU of < 8 hrs.
Inhospital mortality in patients with acute myocardial infarction could be accurately predicted with APACHE II scores. Prognostication was not as good in patients with a length of stay in the medical ICU of < 8 hrs.
研究急性生理与慢性健康状况评分系统II（APACHE II）对急性心肌梗死患者院内死亡率预后评估的有用性。
一项前瞻性验证研究。
一所大学医院的内科重症监护病房（ICU）。
在3年期间，对1714例急性心肌梗死患者的2007次入院进行了研究。在同一住院期间再次入住内科ICU的患者，仅研究首次入院情况。
患者的平均年龄为72±10岁。内科ICU死亡率为13%，总医院死亡率为16%。APACHE II平均评分为11.6±6.5。在不同APACHE II评分的患者类别中，观察到的死亡率与预测死亡率之间存在密切相关性。评分在20至24分的患者中，观察到的死亡率高于预测死亡率（p<0.03）。在该亚组中，25%的患者在内科ICU的住院时间<8小时。
APACHE II评分可准确预测急性心肌梗死患者的院内死亡率。在内科ICU住院时间<8小时的患者中，预后评估效果不佳。
