What is the clinical evidence from this study?

Study design: Observational. Population: Post-cardiac surgery (n=600). Intervention: APACHE II score vs. EuroSCORE. Primary outcome: ICU mortality (AUC 0.743).

September 18, 2018Open Access

The APACHE II Score as a Predictor of Mortality After Open Heart Surgery

Q: What does this research mean for the field?

The APACHE II score successfully predicts ICU mortality in post-cardiac surgery patients, yielding an area under the curve of 0.743 compared to 0.767 for the EuroSCORE. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

MYMihriban YalçınOrdu University EGEda GödekmerdanOrdu University KTKaptanı Derya TayfurOrdu University

Key Result

The APACHE II score successfully predicted ICU mortality in post-cardiac surgery patients, yielding an area under the curve of 0.743 compared to 0.767 for the EuroSCORE.

Study Design

Type

Observational (n=600)

Multicenter

Structured PICO

Does the APACHE II score predict ICU mortality in adult patients after cardiac surgery?

Population

600 adult patients admitted to a cardiovascular surgery ICU following cardiac surgery, mean age 64.77±10.148 years, 30.0% female.

Intervention

APACHE II score assessment

Comparator

EuroSCORE assessment

Outcome

ICU mortalityhard clinical

The APACHE II score demonstrates acceptable discrimination (AUC 0.743) for predicting ICU mortality in post-cardiac surgery patients, comparable to the EuroSCORE.

Main Result

Effect estimate: AUC 0.743

Abstract

OBJECTIVE: The Acute Physiology and Chronic Health Evaluation (APACHE) severity of disease classification system, which is one of the most widely used scoring systems to predict mortality, is used for intensive care units (ICU) patients. This study aimed to evaluate the predictive ability of APACHE II for mortality in patients after undergoing cardiac surgery. We studied if APACHE II could successfully predict the outcome in post-cardiac surgery patients. METHODS: This study involved retrospective data collection of all adult patients who were admitted to Ordu State Hospital cardiovascular surgery ICU following cardiac surgery from August 2013 to December 2015. Area under the receiver operating characteristic (ROC) curve (AUC) values were calculated for the APACHE II model. RESULTS: During the two years of data collection, we included 600 patients with a mean age of 64.77±10.148 years. Of these, 180 (30.0%) were females. The ICU mortality rate was 8.33%, and the mean length of ICU stay was 4.210±6.913 days. The mean pre-operative EuroSCORE was 3.890±2.565, and the mean pre-operative APACHE II score was 6.790±3.617. The AUC values for APACHE II and EuroSCORE were 0.743 and 0.767, respectively. CONCLUSION: The APACHE II model can be used to predict mortality in a Turkish population of patients who have undergone cardiac surgery.

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