Application of APACHE II scores in the General Intensive Care Unit, Lampang Hospital - ผลการใช้คะแนน APACHE II ในการบริหารเตียง หอผู้ป่วย ICU ทั่วไป โรงพยาบาลลำปาง

Abstract

The APACHE II score (Acute Physiology and Chronic Health Evaluation II) was applied for
assessing the severity of illness at ICU discharge. The object of this study was to examine the effects of
the APACHE II scoring on the un-served booking-bed patient rate, ICU mortality, and the post-ICU
mortality rate in Lampang Hospital. An historical controlled design study was conducted. The sample
comprised 762 and 949 patients who were admitted in the general ICU in 2010 and 2011 respectively.
The chi-square for goodness of fit test and Pabon Lasso scatter plot were applied for analyzing
the data. The findings revealed that the un-served booking-bed patient rate decreased, the post-ICU
mortality rate did not change, and the ICU mortality in the general ICU was lower than the standard of
the APACHE II score within the same level (chi-square for goodness of fit test p<0.001). The hospital
performance with APACHE II score was in the third quadrant of Pabon Lasso graph which means there
was a good management and higher effectiveness. The findings of this study confirm that applying the
APACHE II scores to discharge patients from the general ICU is fit and safe. It improves the efficiency
of bed usage; and the quality of care in the general ICU is higher than the standard APACHE II score.
It is appropriate to use this system in other intensive care units in order to provide efficient services to
improve quality of care for severe patients.
Key words: APACHE II score, hospital performance, intensive care unit