Comparison of Performance of APACHE II and SOFA Scoring Systems in Critically Ill Patients Admitted to Intensive Care Unit

Background.Several disease scoring systems have evolved for predicting the mortality in intensive care unit (ICU) patients.We evaluated the performance of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scoring systems in providing mortality risk estimates in critically ill patients.Methods.During March 2015 to March 2016, 160 critically ill patients requiring mechanical ventilation (MV) at our tertiary care teaching hospital in south India were prospectively studied.results.Compared to survivors, non-survivors were significantly older (median [interquartile range, IQR] age [years] 42.5 (28-54.3)versus 33 [22-49.3][p=0.025]); had higher median (IQR) APACHE II score (23 [18-29] versus 15 [11.8-19]); and SOFA score (9 [6-12] versus 5 [4-7] [p<0.001]);required MV for a longer duration (9 [6-13] versus 6 [4-9] days [p=0.048]) and had lesser duration of ICU stay (7 [4-12] versus 13.5 [8-21.3]days [p<0.001]) and hospital stay (9 [7-17.3]versus 16 [11.8-28]days [p<0.001]).APACHE II score (cut-off >17, sensitivity 67.8%, specificity 80%) and SOFA score (cut-off >7, sensitivity 78.9% and specificity 67.1%) performed similarly in predicting mortality (difference between areas under the curve 0.0180; standard error 0.0316; 95% confidence interval, -0.0440 to 0.0800; z statistic 0.569; p=0.569).conclusion.Both APACHE II and SOFA scores appear to be useful tools in predicting mortality in critically ill patients requiring MV in the setting of an ICU in south India.[indian j chest dis allied sci 2019;61:69-74