APACHE II scoring in the injured patient

• Published in: Critical care medicine Vol. 18; no. 8; p. 827
• Main Authors: Rhee, K J, Baxt, W G, Mackenzie, J R, Willits, N H, Burney, R E, O'Malley, R J, Reid, N, Schwabe, D, Storer, D L, Weber, R
• Format: Journal Article
• Language: English
• Published: United States 01-08-1990
• Subjects: Adolescent; Adult; Aircraft; Female; Humans; Injury Severity Score; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Severity of Illness Index; Transportation of Patients; Trauma Severity Indices; Wounds and Injuries - classification; Wounds and Injuries - mortality
• ISSN: 0090-3493
• DOI: 10.1097/00003246-199008000-00006

The purpose of this study was to measure the predictive power of Acute Physiology and Chronic Health Evaluation (APACHE II) with respect to mortality in a group of seriously injured patients and to compare this predictive power with that of the Trauma Score (TS) and the Injury Severity Score (ISS). Six hundred ninety-one helicopter-transported patients were studied. Individual logistic regressions demonstrated that all three scores had significant predictive power when considered individually (TS chi 2 = 136, p less than .0001; APACHE II chi 2 = 171, p less than .0001; ISS chi 2 = 109, p less than .0001). In addition, each severity score added significantly to the predictive power in a stepwise logistic regression (TS chi 2 = 15, p less than .0001; APACHE II chi 2 = 45, p less than .0001; ISS chi 2 = 15, p less than .0001). Areas under the receiver operating curves for the three scores were not significantly different (TS 0.8116, SD 0.0245; APACHE II 0.8515, SD 0.0204; ISS 0.7967; SD 0.0223). APACHE II is a good predictor of mortality, and its predictive power is complemented by TS and ISS.