Acute Physiology and Chronic Health Evaluation II score for the assessment of mortality prediction in the intensive care unit: a single‐centre study from Iran

2019 ◽  
Vol 24 (6) ◽  
pp. 375-380 ◽  
Author(s):  
Mehrzad Bahtouee ◽  
Seyed S Eghbali ◽  
Nasrollah Maleki ◽  
Vahid Rastgou ◽  
Niloufar Motamed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Prediction ◽  
Chronic Health Evaluation ◽  
Health Evaluation ◽  
Single Centre ◽  
Chronic Health ◽  
Centre Study ◽  
Single Centre Study

scholarly journals The significance of National Early Warning Score for predicting prognosis and evaluating conditions of patients in resuscitation room

2018 ◽  
Vol 25 (6) ◽  
pp. 324-330 ◽  
Author(s):  
Wang Chang Yuan ◽  
Cao Tao ◽  
Zhu Dan Dan ◽  
Sun Chang Yi ◽  
Wang Jing ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Warning ◽  
Chronic Health Evaluation ◽  
Early Warning Score ◽  
Health Evaluation ◽  
Chronic Health ◽  
Resuscitation Room ◽  
Receiver Operating Characteristic Curves ◽  
National Early Warning Score

Background: For critical patients in resuscitation room, the early prediction of potential risk and rapid evaluation of disease progression would help physicians with timely treatment, leading to improved outcome. In this study, it focused on the application of National Early Warning Score on predicting prognosis and conditions of patients in resuscitation room. The National Early Warning Score was compared with the Modified Early Warning Score) and the Acute Physiology and Chronic Health Evaluation II. Objectives: To assess the significance of NEWS for predicting prognosis and evaluating conditions of patients in resuscitation rooms. Methods: A total of 621 consecutive cases from resuscitation room of Xuanwu Hospital, Capital Medical University were included during June 2015 to January 2016. All cases were prospectively evaluated with Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II and then followed up for 28 days. For the prognosis prediction, the cases were divided into death group and survival group. The Modified Early Warning Score, National Early Warning Score, and Acute Physiology and Chronic Health Evaluation II results of the two groups were compared. In addition, receiver operating characteristic curves were plotted. The areas under the receiver operating characteristic curves were calculated for assessing and predicting intensive care unit admission and 28-day mortality. Results: For the prognosis prediction, in death group, the National Early Warning Score (9.50 ± 3.08), Modified Early Warning Score (4.87 ± 2.49), and Acute Physiology and Chronic Health Evaluation II score (23.29 ± 5.31) were significantly higher than National Early Warning Score (5.29 ± 3.13), Modified Early Warning Score (3.02 ± 1.93), and Acute Physiology and Chronic Health Evaluation II score (13.22 ± 6.39) in survival group ( p < 0.01). For the disease progression evaluation, the areas under the receiver operating characteristic curves of National Early Warning Score, Modified Early Warning Score, and Acute Physiology and Chronic Health Evaluation II were 0.760, 0.729, and 0.817 ( p < 0.05), respectively, for predicting intensive care unit admission; they were 0.827, 0.723, and 0.883, respectively, for predicting 28-day mortality. The comparison of the three systems was significant ( p < 0.05). Conclusion: The performance of National Early Warning Score for predicting intensive care unit admission and 28-day mortality was inferior than Acute Physiology and Chronic Health Evaluation II but superior than Modified Early Warning Score. It was able to rapidly predict prognosis and evaluate disease progression of critical patients in resuscitation room.

Delirium in Postoperative Patients Admitted to the Intensive Care Unit

2018 ◽  
Vol 84 (6) ◽  
pp. 875-880
Author(s):  
Timothy R. Romanauski ◽  
Erin E. Martin ◽  
Juraj Sprung ◽  
David P. Martin ◽  
Darrell R. Schroeder ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Electronic Health Records ◽  
Assessment Method ◽  
Chronic Health Evaluation ◽  
Surgical Patients ◽  
Health Evaluation ◽  
Health Records ◽  
Chronic Health ◽  
Electronic Health

Postoperative delirium (POD) is common among surgical patients admitted to the intensive care unit (ICU) and is associated with increased resource utilization, morbidity, and death. Our primary aim was to compare rates of POD using administrative International Classification of Diseases, Ninth Revision, records and automated interrogation of electronic health records from Confusion Assessment Method for the ICU (CAM-ICU) screening. The secondary aim was to assess POD risk associated with patient and perioperative characteristics. Electronic health records of surgical patients admitted to the ICU during 2011 through 2014 were abstracted for POD assessment by CAM-ICU and by administrative codes, Charlson comorbidity index, surgical characteristics, and Acute Physiology, Age, Chronic Health Evaluation III scores. Of 6338 patients, CAM-ICU identified 606 (9.6%) and administrative records identified 55 (0.9%) POD cases, with agreement on 50 cases. In multivariable logistic regression based on POD identified with CAM-ICU, preexisting dementia had the strongest association with POD (odds ratio [95% confidence interval], 6.47 [3.68–11.37]; P < 0.001). Other associations found were older age, congestive heart failure, chronic pulmonary disease, increased surgical duration, emergency cases, blood transfusions, postoperative ventilation, and higher Acute Physiology, Age, Chronic Health Evaluation III scores (all P ≤ 0.01). POD cases had lengthier ICU and hospital stays and a higher mortality rate (all P < 0.001). CAM-ICU scores identified higher rates of POD than a search for POD based on administrative codes. Preoperative presence of dementia and major comorbidities were associated with POD. Delirium in surgical patients is associated with worse outcomes.

scholarly journals Acute Physiology and Chronic Health Evaluation (APACHE) II Pada Angka Kematian Pasien Gagal Nafas

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Bambang Suryadi ◽  
Nurul Ainul Shifa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Health Evaluation ◽  
Chi Square ◽  
Cross Sectional ◽  
Chronic Health

Pendahuluan: dalam penentuan kebutuhan dan prognosis kematian pasien diperlukan skoring kematian di Intensive care unit (ICU). Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan skoring Acute Physiology And Chronic Health Evaluation (APACHE II) terhadap angka kematian pada pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor Tahun 2019. Metode: rancangan dalam penelitian ini adalah cross sectional. Jumlah sampel yaitu 56 pasien gagal nafas. Intrumen menggunakan lembar cheklist apache dan uji statistik menggunakan uji Chi Square. Hasil:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas di Ruang ICU Rumah Sakit PMI Bogor dengan Pvalue 0,02 dan OR 4,63. Kesimpulan:Ada hubungan skoring APACHE II terhadap angka kematian pasien gagal nafas. Diharapkan perawat membuat integrasi ICU dengan perhitungan APACHE II di ruang ICU.

Does Acute Physiology and Chronic Health Evaluation II Provide a Valid Metric to Directly Compare Disease Severity in Trauma versus Surgical Intensive Care Unit Patients?

2012 ◽  
Vol 78 (11) ◽  
pp. 1261-1269
Author(s):  
Robert D. Becher ◽  
Michael C. Chang ◽  
J. Jason Hoth ◽  
Jennifer L. Kendall ◽  
H. Randall Beard ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Disease Severity ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
Surgical Intensive Care Unit ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Chronic Health ◽  
Risk Of Death

The Acute Physiology and Chronic Health Evaluation II (APACHE II) score has never been validated to risk-adjust between critically ill trauma (TICU) and general surgical (SICU) intensive care unit patients, yet it is commonly used for such a purpose. To study this, we evaluated risk of death in TICU and SICU patients with pneumonia. We hypothesized that mortality for a given APACHE II would be significantly different and that using APACHE II to directly compare TICU and SICU patients would not be appropriate. We conducted a retrospective review of patients admitted to the TICU or SICU at a tertiary medical center over an 18-month period with pneumonia. Admission APACHE II scores, in-hospital mortality, demographics, and illness characteristics were recorded. One hundred eighty patients met inclusion criteria, 116 in the TICU and 64 in the SICU. Average APACHE II scores were not significantly different in the TICU versus SICU (25 vs 24; P = 0.4607), indicating similar disease severity; overall mortality rates, however, were significantly different (24 vs 50%; P = 0.0004). Components of APACHE II, which contributed to this mortality differential, were Glasgow Coma Score, age, presence of chronic health problems, and operative intervention. APACHE II fails to provide a valid metric to directly compare the severity of disease between TICU and SICU patients with pneumonia. These groups represent distinct populations and should be separated when benchmarking outcomes or creating performance metrics in ICU patients. Improved severity scoring systems are needed to conduct clinically relevant and methodologically valid comparisons between these unique groups.

Sign in / Sign up

Export Citation Format

Share Document