The Prediction of Mortality by Using the APACHE II Scoring System in Intensive Care Unit, Chaophya Hospital - การทำนายอัตราเสียชีวิตโดยใช้ระบบคะแนน APACHE II ในหอผู้ป่วยหนัด โรงพยาบาลเจ้าพระยา

Abstract

        The purpose of this retrospective study was to examine the patient’s mortality and evaluate the performance of Acute Physiology and Chronic Health Evaluation II (APACHE II) in Intensive Care Unit (ICU) of Chaophya hospital. Data were retrospectively collected from the medical records of 113 patients who were admitted at ICU from January to June 2007.

       The results revealed that the mean of patient age was 67 years old (SD 19.45). The length of ICU and hospital stay were 6 days and 11 days respectively. Majority of the patients who were cared for by providers in ICU had respiratory problems. The mean of Glasgow Coma Score (GCS) was 12.60. Results of a laboratory investigation were abnormal i.e. low O2 saturation, elevated WBC and creatinine, and high blood sugar. About 89.4 percent of patients were improved.

         After the test with ROC curve, the area under the curve was 0.869 (95%CI 0.832, 0.961), the best cut-off point was 22 and associated with 91.6 percent sensitivity, 79.2 percent specificity, 34.3 percent positive predictive value and 98.7 percent negative predictive value. The mean of APACHE II was 18.94 and predicted death rate (adjusted) was 27.36 percent (actual mortality = 11%). The APACHE II scoring system showed good discrimination. The APACHE II score of non-survivors was higher than that of the survivors in ICU however APACHE II reportedly shows overprediction of mortality.

Key words: APACHE II, mortality