Evaluation of acute physiology and chronic health evaluation IV score and sequential organ failure assessment score in predicting outcome of patients in respiratory intensive care unit

• Published in: Al-Azhar Assiut medical Journal : AAMJ Vol. 15; no. 4; pp. 172 - 178
• Main Authors: Naglh, Ahmad, Zedan, Moustafa, Arafa, Mahmoud, Alzeftawy, Mohammad
• Format: Journal Article
• Language: English
• Published: Wolters Kluwer - Medknow Publications 01-01-2017; Wolters Kluwer Medknow Publications
• Subjects: acute physiology and chronic health evaluation iv score; respiratory intensive care unit; sequential organ failure assessment score; acute physiology and chronic health evaluation IV score; sequential organ failure assessment score; respiratory intensive care unit
• ISSN: 1687-1693
• DOI: 10.4103/AZMJ.AZMJ_25_17

Background Scoring systems in ICU allow assessment of severity of the disease and provide an estimate of in-hospital mortality. And they quantify the severity of illness for hospital and health care system administration.
Objective The objective of this study was to detect the ability of acute physiology and chronic health evaluation (APACHE) IV score and sequential organ failure assessment (SOFA) score in predicting outcome of patients in respiratory intensive care unit (RICU).
Patients and methods A prospective observational cohort study was performed at the RICU of Bab El-Sha'eria and Al-Hussein Al-Azhar University hospitals. The study includes all critically ill patients admitted to the RICU between November 2014 and November 2016. Data were collected from 100 patients (42 female and 58 male) consecutively admitted to the RICU (aged ≥18 years and ICU stay of ≤24 h). Mean of APACHE IV score, length of stay, and predicted mortality rate were calculated during the first 24 h. Mean of SOFA score and length of stay were calculated during the admission. Data were analyzed with SPSS versus version 15.
Results In 100 patients, the observed mortality rate was 49%. The mean age in survived patients was 57.216±12.588 years and in nonsurvived patients was 62.694±10.304 years. APACHE IV score more than 81 was kept as cutoff point, with sensitivity of 81.6% and specificity of 80.4% with area under receiver operating characteristic curve of 0.841. SOFA score more than 7 was kept as cutoff point, with sensitivity of 95.9% and specificity of 100% with area under receiver operating characteristic curve of 0.997.
Conclusion The mortality prediction by APACHE IV and SOFA scoring systems performs acceptably in our patients, and they can be used as performance assessment tools in our RICUs. Both scores showed good discrimination between survived and nonsurvived patients, with SOFA score being more accurate in predicting mortality than APACHE IV.