Background There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12–24), 67 (36.5–88) and 44 (27–56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1–46.0), 18.5% (IQR 3.8–41.8) and 34.8% (IQR 7.9–59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p < 0.05): APACHE II (AUC = 0.78; 95%CI 0.73–0.83), APACHE III (AUC = 0.79; 95%CI 0.74–0.84) and SAPS II (AUC = 0.79; 95%CI 0.74–0.84); as well as mortality after hospital discharge (p < 0.05): APACHE II (AUC = 0.71; 95%CI 0.64–0.78), APACHE III (AUC = 0.72; 95%CI 0.65–0.78) and SAPS II (AUC = 0.69; 95%CI 0.62–0.76), with no statistically significant difference between the scores (p > 0.05). The calibration of the scores was good. Conclusions All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

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Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed. Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.78; 95%CI 0.73-0.83), APACHE III (AUC=0.79; 95%CI 0.74-0.84) and SAPS II (AUC=0.79; 95%CI 0.74-0.84); as well as mortality after hospital discharge (p<0.05): APACHE II (AUC=0.71; 95%CI 0.64-0.78), APACHE III (AUC=0.72; 95%CI 0.65-0.78) and SAPS II (AUC=0.69; 95%CI 0.62-0.76), with no statistically significant difference between the scores (p>0.05). The calibration of the scores was good. Conclusions. All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

Background. There are several scores used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Moreover, their use in assessing post-discharge mortality in intensive care unit (ICU) survivors has not been extensively studied. We aimed to validate APACHE II, APACHE III and SAPS II scores in short- and long-term mortality prediction in a mixed adult ICU in Poland. APACHE II, APACHE III and SAPS II scores, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to a 10-bed ICU in 2016. Short-term (in-hospital) and long-term (12-month post-discharge) mortality was assessed.Results. Median APACHE II, APACHE III and SAPS II scores were 19 (IQR 12-24), 67 (36.5-88) and 44 (27-56) points, with corresponding in-hospital mortality ratios of 25.8% (IQR 12.1-46.0), 18.5% (IQR 3.8-41.8) and 34.8% (IQR 7.9-59.8). Observed in-hospital mortality was 35.6%. Moreover, 12-month post-discharge mortality reached 17.4%. All the scores predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.78; 95%CI 0.73-0.83), APACHE III (AUC=0.79; 95%CI 0.74-0.84) and SAPS II (AUC=0.79; 95%CI 0.74-0.84); as well as mortality after hospital discharge (p<0.05): APACHE II (AUC=0.71; 95%CI 0.64-0.78), APACHE III (AUC=0.72; 95%CI 0.65-0.78) and SAPS II (AUC=0.69; 95%CI 0.62-0.76), with no statistically significant difference between the scores (p>0.05). The calibration of the scores was good.Conclusions. All the scores are acceptable predictors of in-hospital mortality. In the case of post-discharge mortality, their diagnostic accuracy is lower and of borderline clinical relevance. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.

Background. There are several scoring systems used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Also, their use in assessing post-discharge mortality in the ICU survivors has not been extensively studied.Aim. To evaluate the ability of APACHE II, III and SAPS II to predict in-hospital and post-discharge mortality in adult ICU patients.Material and methods. APACHE II, APACHE III and SAPS II, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to the 10-bed ICU in 2016. Long-term mortality was calculated based on information taken from PESEL database.Results. Median APACHE II, APACHE III and SAPS II scores were 19, 67 and 44 points, with corresponding in-hospital mortality ratios of 28.1, 18.5 and 34.8%. Observed in-hospital mortality was 35.6%. 12-month post-discharge mortality reached 17.4%. All systems predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.783; 95%CI 0.732-0.828), APACHE III (AUC=0.793; 95%CI 0.743-0.838) and SAPS II (AUC=0.792; 95%CI 0.742-0.836), as well as mortality after ICU discharge (p<0.05): APACHE II (AUC=0.712; 95%CI 0.643-0.775), APACHE III (AUC=0.721; 95%CI 0.653-0.783) and SAPS II (AUC=0.695; 95%CI 0.625-0.759), with no statistically significant difference between them (p>0.05).Conclusions. Although the predictive values were the highest for APACHE III and SAPS II, no differences were noticed between the scores. In case of post-discharge mortality, diagnostic accuracy was much lower. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.