Comparative Analysis of Scoring Systems for Predicting Rehospitalisation, Mortality and Adverse Outcomes in the Intensive Cardiovascular Care Unit

Introduction: The intensive cardiovascular care unit (ICCU) specializes in treating cardiovascular disease patients, often those with comorbidities. Our study conducted a comparative analysis of four scoring systems — APACHE II, SAPS II, MPM II, and SOFA— to evaluate their effectiveness in predicting mortality, rehospitalisation, major adverse cardiovascular events (MACE), and length of stay (LOS) in patients admitted to the ICCU. Methods: We included 139 patients admitted between January 2020 and January 2022 to the ICCU. The prognostic scales used were the APACHE II, SAPS II, MPM II, and SOFA, which were retrospectively calculated using data from the first 24 hours after ICCU admission. Results: The most common diagnosis for admission to the ICCU was decompensated heart failure. The mortality rate was 16.5%. The MPM II, SAPS II, and SOFA scores were significantly associated with mortality. The APACHE II score did not significantly correlate with mortality, possibly due to the heterogeneity of patient conditions. The APACHE II and MPM II scores were significant predictors of rehospitalisation, with no significant associations found for the SOFA and SAPS II scores. All four scoring systems were significantly associated with tells, indicating that higher scores predict longer stays in the ICCU. No significant association was found between the scores and MACE, possibly due to the study's small sample size. Conclusion: This study is the first to evaluate these scores for ICCU patients and to explore outcomes such as rehospitalisation, MACE, and LOS. This highlights the potential of the MPM II score for predicting both mortality and rehospitalisation, suggesting that these scoring systems could improve clinical practice.