Prediction of Outcome in Critically Ill Elderly Patients using APACHE II and SOFA Scores

Abstract

Performances of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score were assessed in predicting mortality outcome in critically ill elderly patients. Mean APACHE II and SOFA scores were compared in 106 intensive care unit patients aged > 65 years classified as survivors or deaths. The discriminatory ability of the scores was evaluated using the area under the receiver operating characteristic (ROC) curve. Calibration was assessed using the Hosmer-Lemeshow test. Mean APACHE II and SOFA scores in survivors were lower than in those who died. There was a positive correlation between the APACHE II and SOFA scores. The area under the ROC curve was 0.76 for the APACHE II score and ranged from 0.74 for the initial SOFA score to 0.98 for the maximum SOFA score. Hosmer-Lemeshow values for the APACHE II score and various SOFA scores indicated that predictions based on these scores closely fit the observed outcomes. APACHE II and SOFA scores can accurately predict mortality outcome in critically ill elderly patients, especially the maximum SOFA score and the difference between the maximum and initial SOFA scores.