Comparing APACHE II, APACHE IV, SAPS II, and SOFA Predictive Power in Poisoned Patients Admitted to the Intensive Care Unit
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 10 No. 2 (2020),
21 June 2020
,
Page 28814
https://doi.org/10.32598/ijmtfm.v10i2.28814
Abstract
Background: This study aimed to assess the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiologic Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) scores in predicting mortality rate in poisoning patients admitted to an intensive care unit (ICU).
Methods: This cross-sectional study was performed on all admitted patients in the poisoning ICU of Imam Reza Hospital, Mashhad City, Iran. All patients were evaluated for three consecutive days since admission time and then every two days until discharge from ICU or death. The scoring systems mentioned above were calculated and analyzed by MedCalc statistical software version 18.9.1 and SPSS version 16.
Results: Overall, 150 patients were studied, out of whom 67% (101) were male. Their mean±SD age was 41.6±18.9 years. In their whole hospitalization period, APACHE II (79.5%), SAPS II (78.7%), APACHE IV (78.4%), and SOFA (72.9%) were the most precise measures. On the first day of admission APACHE II (77.4%), on the second day, APACHE II (83.1%), on the third day, APACHE II (90.7%), and on the fifth day, SOFA (81.6%) were the most precise measures.
Conclusion: All four systems have acceptable discriminatory power for poisoned patients. However, it seems that APACHE II can be used for mortality prediction, especially in the early days of admission.
- Critical زare
- Prognostic models
- Acute Physiology And Chronic Health Evaluation (APACHE)
- Simplified acute physiology score
- Organ dysfunction scores
How to Cite
References
Sawalha AF, Sweileh WM, Tufaha MT, Al‐Jabi DY. Analysis of the pattern of acute poisoning in patients admitted to a governmen-tal hospital in Palestine. Basic Clin Pharmacol Toxicol. 2010; 107(5):914-8. [DOI:10.1111/j.1742-7843.2010.00601.x] [PMID]
Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th Ann report. Clin Toxicol (Phila). 2016; 55(10):1072-254. [DOI:10.1080/15563650.2017.1388087] [PMID]
Alinejad S, Zamani N, Abdollahi M, Mehrpour O. A narrative review of acute adult poisoning in Iran. Iran J Med Sci. 2017; 42(4):327. [PMCID]
Nikfar S, Khatibi M, Abdollahiasl A, Abdollahi M. Cost and utilization study of antidotes: An Iranian experience. Int J Pharmacol. 2011; 7(1):46-9. [DOI: 10.3923/ijp.2011.46.49]
Park SK, Chun HJ, Kim DW, Im TH, Hong HJ, Yi HJ. Acute physiology and chronic health evaluation ii and simplified acute physiology score ii in predicting hospital mortality of neurosurgical intensive care unit patients. J Korean Med Sci. 2009; 24(3):420-6. [DOI:10.3346/jkms.2009.24.3.420] [PMID] [PMCID]
Sakr Y, Krauss C, Amaral AC, Réa-Neto A, Specht M, Reinhart K, Marx G. Comparison of the performance of SAPS II, SAPS 3, APACHE II, and their customized prognostic models in a surgical intensive care unit. Br J Anaesth. 2008; 101(6):798-803. [DOI:10.1093/bja/aen291] [PMID]
Hosmer DW, Lemeshow S. Assessing the Fit of the Model. In: Hosmer DW, Lemeshow S, editors. Applied Logistic Regression. 2nd ed. New York: John Wiley & Sons; 2000. [DOI:10.1002/0471722146.ch5]
Ratanarat R, Thanakittiwirun M, Vilaichone W, Thongyoo S, Permpikul C. Prediction of mortality by using the standard scoring systems in a medical intensive care unit in Thailand. J Med Assoc Thai. 2005; 88(7):949-55. [PMID]
Alizadeh AM, Hassanian-Moghaddam H, Shadnia S, Zamani N, Mehrpour O. Simplified acute physiology score II/acute physiol-ogy and chronic health evaluation II and prediction of the mortality and later development of complications in poisoned patients admitted to intensive care unit. Basic Clin Pharmacol Toxicol. 2014; 115(3):297-300. [DOI:10.1111/bcpt.12210] [PMID]
Lee JH, Hwang SY, Kim HR, Kim YW, Kang MJ, Cho KW, et al. Effectiveness of the sequential organ failure assessment, acute physiology and chronic health evaluation II, and simplified acute physiology score II prognostic scoring systems in paraquat-poisoned patients in the intensive care unit. Hum Exp Toxicol. 2017; 36(5):431-7. [DOI:10.1177/0960327116657602] [PMID]
Sun D, Ding H, Zhao C, Li Y, Wang J, Yan J, et al. Value of SOFA, APACHE IV and SAPS II scoring systems in predicting short-term mortality in patients with acute myocarditis. Oncotarget. 2017; 8(38):63073-83. [DOI:10.18632/oncotarget.18634] [PMID] [PMCID]
Exarchopoulos T, Charitidou E, Dedeilias P, Charitos C, Routsi C. Scoring systems for outcome prediction in a cardiac surgical in-tensive care unit: A comparative study. Am J Crit Care. 2015; 24(4):327-34. [DOI:10.4037/ajcc2015500] [PMID]
Sharma S, Gupta A, Virmani SK, Lal R. Assessment and comparison of 3 mortality prediction models SAPS II, APACHE II and SOFA for prediction of mortality in patients of sepsis. Int J Adv Med. 2017; 4(3):623-9. [DOI:10.18203/2349-3933.ijam20171476]
Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European society of intensive care medicine. Intensive Care Med. 1996; 22(7):707-10. [DOI:10.1007/bf01709751] [PMID]
Liisanantti JH, Ohtonen P, Kiviniemi O, Laurila JJ, Ala-Kokko TI. Risk factors for prolonged intensive care unit stay and hospital mortality in acute drug-poisoned patients: an evaluation of the physiologic and laboratory parameters on admission. J Crit Care. 2011; 26(2):160-5. [DOI:10.1016/j.jcrc.2010.08.009] [PMID]
Shadnia S, Zamani N, Hassanian-Moghaddam H, Shafaroodi H, Padandar M, Rezaeizadeh MH. Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU. World J Emerg Med. 2018; 9(1):51-5. [DOI:10.5847/wjem.j.1920-8642.2018.01.008] [PMID] [PMCID]
Khodabandeh F, Shadnia S, Pormatine M. Performance assessment of the acute physiology and chronic health evaluation iv scoring system in outcome of patients fallowing acute poisoning. Novelty Biomed. 2018; 6(4):174-9. [DOI: 10.22037/nbm.v6i4.21277]
Sungurtekin H, Gurses E, Balci C. Evaluation of several clinical scoring tools in organophosphate poisoned patients. Clin Toxicol (Phila). 2006; 44(2):121-6. [DOI:10.1080/15563650500514350] [PMID]
Kim YH, Yeo JH, Kang MJ, Lee JH, Cho KW, Hwang S, et al. Performance assessment of the SOFA, APACHE II scoring system, and SAPS II in intensive care unit organophosphate poisoned patients. J Korean Med Sci. 2013; 28(12):1822-6. [DOI:10.3346/jkms.2013.28.12.1822] [PMID] [PMCID]
Godinjak A, Iglica A, Rama A, Tancica I, Jusufovic S, Ajanovic A, et al. Predictive value of SAPS II and APACHE II scoring sys-tems for patient outcome in a medical intensive care unit. Acta Medica Academica. 2016; 45(2):97-103. [DOI:10.5644/ama2006-124.165]
Fadaizadeh L, Tamadon R, Saeedfar K, Jamaati HR. Performance assessment of acute physiology and chronic health evaluation ii and simplified acute physiology score ii in a referral respiratory intensive care unit in Iran. Acta Anaesthesiol Taiwan. 2012; 50(2):59-62. [DOI:10.1016/j.aat.2012.05.004] [PMID]
Ibrahim MA, El Masry MK, Moustafa AA, Hagras AM, Ali NM. Comparison of the accuracy of two scoring systems in predicting the outcome of organophosphate intoxicated patients admitted to Intensive Care Unit (ICU). Egypt J Forensic Sci. 2011; 1(1):41-7. [DOI:10.1016/j.ejfs.2011.04.013]
- Abstract Viewed: 403 times
- PDF Downloaded: 405 times