Effectiveness of APACHE II and SAPS II scoring models in foreseeing the outcome of critically ill COPD patients

Mohamed Adam,Lamees M. Bakkar,Yousef Ahmed

doi:10.4103/ejb.ejb_72_19

Abstract

BackgroundAcute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems are the two models that are greatly used by the majority of ICUs to predict clinical consequence.ObjectiveThe aim of the study was to assess the performance of APACHE II and SAPS II scoring methods in foreseeing death among critically ill chronic obstructive pulmonary disease (COPD) patients.Materials and methodsThis prospective research included 104 COPD patients who were admitted to the respiratory intensive care unit (RICU) at Assiut University Hospital. The patients were classified as survivors and nonsurvivors. Each scoring system was assessed for its discrimination, calibration, and overall performance.ResultsOn the basis of the outcome of the study population, 36 (34.6%) patients were non-survivors while 68 (65.4%) patients were survivors. Both APACHE II and SAPS II scores were significantly higher in nonsurvivors. The discriminative power of both models was good as determined by the receiver operating characteristic curve. At a cutoff point greater than 20 for APACHE II and greater than 48 for SAPS II, survival or death can be predicted. The Lemeshow–Hosmer goodness-of-fit C statistics showed good performance and good calibration for both models. APACHE II score had the least Brier score and reliability but had the highest resolution.ConclusionThe conclusions made were first, APACHE II and SAPS II have nearly similar performance in predicting mortality among COPD patients but with some preference for APACHE. Second, Both models have good discrimination and good calibration.

Highlights

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating airway disease that results in a large burden, both medically and financially
On the basis of the outcome of the study population, 36 (34.6%) patients were non-survivors while 68 (65.4%) patients were survivors. Both APACHE II and Simplified Acute Physiology Score II (SAPS II) scores were significantly higher in nonsurvivors
Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems are the two models that are greatly used by the majority of ICUs to forecast the clinical consequence [5]

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating airway disease that results in a large burden, both medically and financially It affects millions of people around the world and causes great rates of morbidity and mortality. The use of scoring models developed for patient evaluation at the time of ICU entry has decreased many troubles and helped therapy delineation These methods aid in assessing and comparing the goodness and magnitude of care between different health-care academies [3,4]. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems are the two models that are greatly used by the majority of ICUs to forecast the clinical consequence [5]. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) scoring systems are the two models that are greatly used by the majority of ICUs to predict clinical consequence

Methods

Results

Discussion

Conclusion