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2001, Number 2

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Med Crit 2001; 15 (2)

Mortality in the intensive care unit: Evaluation with a prognostic scoring system

Blas MJ, Nava MS, Juárez OA

Language: Spanish
References: 25
Page: 41-44
PDF size: 56.01 Kb.


ABSTRACT

Objective: To evaluate the predictive value of APACHE II score on mortality in an ICU of Mexico. Design: Prospective study. Setting: ICU of a second care level, Durango, Mexico. Patients: A total of 211 patients were included and evaluated during the first 24 hours in the ICU. Interventions: None. Measurements and main results: Of a total of 250 patients admitted to the ICU were evaluated 211. The following data were found in survivors (n = 150) and non survivors (n = 52): mean age 60 ± 17.8 vs 55 ± 19.4 years (NS), temperature 36.4 ± 0.8 vs 36.7 ± 1.2°C (p ‹ 0.05), heart rate 93 ± 265 vs 108 ± 26 beats/min (p ‹ 0.05), serum creatinine 1.32 ± 0.88 vs 2.25 ± 1.71 mg/dL (p ‹ 0.05) and APACHE II score 13.9 ± 9.1 vs 23.1 ± 8.6 points (p ‹ 0.05). The predictive mortality was 37.7% and the observed mortality 29.8% (NS). Conclusion: APACHE II score is useful to evaluate the mortality in an ICU of second level of Mexico.


REFERENCES

  1. Thibault GE, Mulley AG, Barnett GO et al. Medical Intensive Care: Indications, Interventions, and autcomes. N Engl J Med 1980; 302: 938-42.

  2. Jackson BS. A one year mortality study of the most acutely-ill patients in a medical-surgical intensive care unit: Toward developing a model for selection of recipients of intensive care. Heart and lung 1984; 13:132-137.

  3. Cerra FB, Negro F, Abrams J. APACHE II Score does not predict multiple organ failure of mortality in postoperative surgical patients. Arch Surg 1990; 125: 519-522.

  4. Teres D, Lemeshow S. Why severity models should be used with caution. Crit Care Clin 1994; 10: 91-110.

  5. Le Gall JR, Leneshow S. Do we need a new severity score? Crit Care Med 1991; 19: 857-858.

  6. Knaus WA, Zimmerman JE, Wagner DP et al. APACHE acute physiology and chronic health evaluation: A physiologically based classification system. Crit Care Med 1981; 9: 591-597.

  7. LeGall JR, Loirat P, Alperovich A et al. A simplified acute physiology score for ICU patients. Crit Care Med 1984; 12: 975-977.

  8. Knaus WA, Draper EA, Waner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 11: 818-829.

  9. Lemeshow S, LeGall JR. Modelling the severity of illness of ICU patients: A systems update. JAMA 1994; 272: 1049-1055.

  10. Beck DH, Taylor BL, Millarr B et al. Prediction of outcome from intensive care: A prospective cohort study comparing. Acute physiology and Chronic Health Evaluation II and III pronostic Systems in a United Kingdom intensive care unit. Crit Care Med 1997; 25: 9-15.

  11. Moreno R, Morais P. Outcome prediction in intensive care: Results of a prospective multicentre, Portuguese study. Intensive Care Med 1997; 23: 177-186.

  12. Álvarez M, Nava JM, Rue M et al. Mortallty prediction in head-trauma patients; Performance of Glasgow Coma Score and general severity systems. Crit Care Med 1998; 26: 142-148.

  13. Moreau R, Soupison T, Vanquelin P et al. Comparison of two simplified severity Score (SAPS and APACHE II) for patients with acute myocardial infarction. Crit Care Med 1989; 17: 409-412.

  14. Bhagwanjee S, Paru KF, Moodley J et al. Intensive Care unit morbility and mortality from eclampsia: An evaluation of the Acute physiology and Chronic Health Evaluation II Score and the Glasgow Coma Scale Score. Crit Care Med 2000; 28: 120-124.

  15. ElSolh AA, Grant BJ. A Comparison of illness scoring systems for critically ill obstetric patients. Chest 1996; 110: 1299-1304.

  16. Sackett D, Haynes R, Guyatt G, Tugwell P. Epidemiología Clínica. Ciencia básica para la medicina clínica. Argentina: Panamericana 1997.

  17. Bastos PG, Sun Y, Wagner DP et al. Application of the APACHE III prognostic Score in Brazilian Intensive Care Med. Crit Care Med 1996; 22: 564-510.

  18. Multicenter Italian group of research in Intensive Therapy and Intensive Medicine in a metropolitan area An epidemiologic study. Minerva Anestesiol 1993; 59: 63-67.

  19. Oh TE, Hutchinson R, Shorts E. Verification of the Acute Phisiology and Chronic Health evaluation scoring system in a Hong Kong Intensive Care Unit. Crit Care Med 1993; 21: 698-705.

  20. Worig DT, Crofts SL, Gomez M et al. Evaluation of predictive ability of APACHE II system and hospital outcome in Canadian Intensive Care patients. Crit Care Med 1995; 23: 1177-1183.

  21. Sirio CA, Tajimi K, Tase C et al. An initial comparison of Intensive Care in Japan and the United States. Crit Care Med 1992; 20: 1207-1215.

  22. Knaus WA, Drape EA, Wagner DP et al. An evaluation of outcome from intensive care in major medical centers. Ann Int Med 1986; 104: 410-418.

  23. Knaus WA, Wagner DP, Draper EA et al. The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991; 100: 1619-1636.

  24. Knaus WA, Wagner DP, Zimmerman JE et al. Variations in mortality and length of stay in intensive care units. Ann Intern Med 1993; 118: 753-761.

  25. Lemeshow S, LeGall JR. Modifying the severity of illness of ICU patients. A systems update. JAMA 1994; 272: 1049-1055.




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