What question did this study set out to answer?

To determine the consistency and applicability of the APACHE II scoring system in a Swiss surgical intensive care unit and compare its predictive utility against established historical benchmarks.

December 1, 1992Critical Care Medicine

Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit

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Why the study?

Does the APACHE II scoring system accurately predict hospital mortality in a Swiss surgical ICU population?

Population

2,061 consecutive patients admitted to a surgical ICU, mean age 53 +/- 16 years, in a Swiss university…

Comparison

Acute Physiology and Chronic Health Evaluation… vs Historical cohort studied by Knaus et al. in 1985

Design

Cohort

Follow-up

Until hospital discharge (hospital mortality rate)

Authors

MBMette M. BergerUniversity of Lausanne AMAlfio MarazziUniversity of Lausanne JFJames FreemanFermi National Accelerator Laboratory

Discussion

Member takes

Implication

APACHE II may aid mortality prediction in Swiss surgical ICUs; leaves open need for prospective validation before routine adoption.

Key Points

To determine the consistency and applicability of the APACHE II scoring system in a Swiss surgical intensive care unit and compare its predictive utility against established historical benchmarks.
Prospective 2-year study evaluating 2,061 consecutive admissions (elective surgery, emergency surgery, and nonoperative) to a surgical ICU in a Swiss university hospital.
Assessed hospital mortality rates, calculated receiver operating characteristic curves, and compared findings with a historical cohort of 5,815 patients.
Mean APACHE II scores were significantly lower in survivors (9.0 ± 5.2, n=1,813) than in nonsurvivors (21.5 ± 8.5, n=248; p < .001).
Sensitivity and specificity of the scores reached 87% and 78% in emergency surgery patients, but were lowest in elective surgery patients at 76% and 73%.
Mortality rates were higher in Swiss patients with high scores (postoperative 20–29 and nonoperative >24) relative to the historical benchmark, indicating that the equation underestimated risk of death.

Structured PICO

Does the APACHE II scoring system accurately predict hospital mortality in a Swiss surgical ICU population?

Population

2,061 consecutive patients admitted to a surgical ICU (classified as postoperative elective/emergency and nonoperative), mean age 53 +/- 16 years, in a Swiss university hospital.

Intervention

Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system

Comparator

Historical cohort studied by Knaus et al. in 1985 (n=5,815)

Outcome

Hospital mortality rate predictability

The APACHE II score demonstrated consistency over time and can be used to predict mortality in a Swiss surgical ICU without modification.

Cite This Study

Berger et al. (1992) studied this question.

synapsesocial.com/papers/6a6f967fabc331a858078f3f https://doi.org/10.1097/00003246-199212000-00014

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Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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