Evaluation of Acute Physiology and Chronic Health Evaluation II and sequential organ failure assessment scoring systems for prognostication of outcomes among Intensive Care Unit's patients

Context:

Acute Physiology and Chronic Health Evaluation II (APACHE II) and sequential organ failure assessment (SOFA) are of the most validated and prevalent general scoring systems over the world.

Aims:

The aim of the current study was to evaluate APACHE II and SOFA ability in predicting the outcomes (survivors, nonsurvivors) in surgical and medical Intensive Care Unit (ICU).

Setting and Design:

This was an observational and prospective study of 300 consecutive patients admitted in surgical and medical ICU during a 6-month period.

Materials and Methods:

APACHE II and SOFA scores and demographic characteristics were recorded for each patient separately in the first admission 24 h.

Statistical Analysis Used:

Receiver operator characteristic (ROC) curves, Hosmer–Lemeshow test, and logistic regression were used in the statistical analysis (95% confidence interval).

Results:

Data analysis showed a significant statistical difference in APACHE II and SOFA scores between survivor and nonsurvivor patients (P < 0.0001, P = 0.001; respectively). The discrimination power was acceptable for APACHE II and poor for SOFA (area under ROC [AUC] curve: 73.7% (standard error [SE]: 3.2%), 63.4% [SE: 3.6%]; respectively). The acceptable calibration was seen just for SOFA (χ² = 11.018, P = 0.051).

Conclusions:

Both APACHE II and SOFA showed good predictive accuracy for results in surgical and medical ICUs; however, the SOFA is the choice to select, because of being simpler and easier to record data.