Apache Ii

Knaus, William A.; Draper, Elizabeth A.; Wagner, Douglas P.; Zimmerman, Jack E.

doi:10.1097/00003246-198510000-00009

Cited by 12,263 publications

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“…It appears however that the APACHE II score is nowadays outdated. Interestingly, Knaus, the APACHE II original developer, advised that researchers should discontinue the use of the APACHE II for outcome assessment [20].…”

Section: Discussionmentioning

confidence: 99%

SAPS 3 admission score: an external validation in a general intensive care population

et al. 2008

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Objectives: To validate the SAPS 3 admission score in an independent general intensive care case mix and to compare its performances with the APACHE II and the SAPS II scores. Design: Cohort observational study. Setting: A 26-bed general ICU from a Tertiary University Hospital. Patients and participants: Eight hundred and fifty-one consecutive patients admitted to the ICU over an 8-month period. Of these patients, 49 were readmissions, leaving 802 patients for further analysis. Intervention: None. Measurements and results: APACHE II, SAPS II and SAPS 3 variables were prospectively collected; scores and their derived probability of death were calculated according to their original manuscript description. The discriminative power was assessed using the area under the ROC curve (AUROC) and calibration was verified with the Hosmer-Lemeshow goodness-of-fit test. The AUROC of the APACHE II model (AUROC = 0.823) was significantly lower than those of the SAPS II (AUROC = 0.850) and SAPS 3 models (AUROC = 0.854) (P = 0.038). The calibration of the APACHE II model (P = 0.037) and of the SAPS 3 global model (P = 0.035) appeared unsatisfactory. On the contrary, both SAPS II model and SAPS 3 model customised for Central and Western Europe had a good calibration. However, in our study case mix, SAPS II model tended to overestimate the probability of death. Conclusion: In this study, the SAPS 3 admission score and its prediction model customised for Central and Western Europe was more discriminative and better calibrated than APACHE II, but it was not significantly better than the SAPS II.

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Section: Discussionmentioning

confidence: 99%

SAPS 3 admission score: an external validation in a general intensive care population

et al. 2008

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“…Intubation and mechanical ventilation (MV) requirements, adverse events during ICU stay (for example, the need for vasopressor drugs or renal replacement therapies) and laboratory findings at ICU admission were also recorded. To determine the severity of illness, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score [7] was determined in all patients within 24 hours of ICU admission. Organ failure was assessed using the Sequential Organ Failure Assessment (SOFA) scoring system [8].…”

Section: Methodsmentioning

confidence: 99%

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

et al. 2011

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IntroductionLittle information exists about the impact of acute kidney injury (AKI) in critically ill patients with the pandemic 2009 influenza A (H1N1) virus infection.MethodsWe conducted a prospective, observational, multicenter study in 148 Spanish intensive care units (ICUs). Patients with chronic renal failure were excluded. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria.ResultsA total of 661 patients were analyzed. One hundred eighteen (17.7%) patients developed AKI; of these, 37 (31.4%) of the patients with AKI were classified as AKI I, 15 (12.7%) were classified as AKI II and 66 (55.9%) were classified as AKI III, among the latter of whom 50 (75.7%) required continuous renal replacement therapy. Patients with AKI had a higher Acute Physiology and Chronic Health Evaluation II score (19.2 ± 8.3 versus 12.6 ± 5.9; P < 0.001), a higher Sequential Organ Failure Assessment score (8.7 ± 4.2 versus 4.8 ± 2.9; P < 0.001), more need for mechanical ventilation (MV) (87.3% versus 56.2%; P < 0.01, odds ratio (OR) 5.3, 95% confidence interval (CI) 3.0 to 9.4), a greater incidence of shock (75.4% versus 38.3%; P < 0.01, OR 4.9, 95% CI, 3.1 to 7.7), a greater incidence of multiorgan dysfunction syndrome (92.4% versus 54.7%; P < 0.01, OR 10.0, 95% CI, 4.9 to 20.21) and a greater incidence of coinfection (23.7% versus 14.4%; P < 0.01, OR 1.8, 95% CI, 1.1 to 3.0). In survivors, patients with AKI remained on MV longer and ICU and hospital length of stay were longer than in patients without AKI. The overall mortality was 18.8% and was significantly higher for AKI patients (44.1% versus 13.3%; P < 0.01, OR 5.1, 95% CI, 3.3 to 7.9). Logistic regression analysis was performed with AKIN criteria, and it demonstrated that among patients with AKI, only AKI III was independently associated with higher ICU mortality (P < 0.001, OR 4.81, 95% CI 2.17 to 10.62).ConclusionsIn our cohort of patients with H1N1 virus infection, only those cases in the AKI III category were independently associated with mortality.

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“…Modern scale systems, such as the Abbreviated Injury Scale (AIS), Іnjury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS), Trauma Score -Injury Severity Score (TRISS), APACHE II (Acute Physiology and Chronic Health Evaluation II) and SOFA (Sequential Organ Failure Assessment) [1,9], help to evaluate the severity of the patient's condition (including multiple injured patients), but do not help to make the decision of choosing the proper tactics of general surgical and orthopedic management.…”

Section: Discussionmentioning

confidence: 99%

Choice of Optimal Time and Type of Orthopedic Surgery in Multiple Injured Patients with Acute Respiratory Distress Syndrome (ARDS) Depending on Age: Retrospective Study

Stanislavovych¹,

Vasylivna²

2013

Ortop Traumatol Rehabil

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SUMMARYBackground. Multiple traumatic injuries are severe conditions with a high risk of complications. He morrhage, multiple organ failure syndrome (MOFS), systemic inflammatory response syndrome (SIRS) and sepsis are the most dangerous sequelae. ARDS (acute respiratory distress syndrome) is a part of MOFS. Despite new strategies of prevention and care, the mortality associated with these conditions still remains high.Materials and methods. We conducted a retrospective study of the surgical management tactic of 145 patients with multiple trauma complicated by ARDS. All patients were treated in Ivano-Frankivsk Regional Clinical Hospital between 2007 and 2012. There were 118 (81.4%) males and 27 (18.6%) females. Patients were divided into two age groups. Group I consisted of 113 (78%) patients aged 18-64 years, including 106 (94%) males and 7 (6%) females. Group II consisted of 32 (22%) patients over 65 years old, with 7 (21.8%) males and 25 (78.2%) females. AISS-NISS (Abbreviated Injury Severity Score -New Injury Severity Score) scores were 55.9±1.312 in Group I and 54.9±2.43 in Group II.Results. The difference in emergency surgery timing between Group І and ІІ was not significant (р>0.05). Age was an important criterion in defining optimal time of osteosynthesis (р<0.01). The choice of osteosynthesis type did not depend on patient age in the early period of trauma (1-3 days) (р>0.05), but the surgical tactic was significantly different in the late period (8 days and more) (р<0.01). Active fracture management with a stable osteosynthesis technique (intramedullary nailing, plating and external fixation) was preferred in the younger age group.Conclusions. 1. The age of the patient is quite an important factor defining the surgical tactic. 2. However, neither age nor severity of injury to the anatomical segments is a reliable criterion for assessing the severity of a patient's condition.

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Apache Ii

Cited by 12,263 publications

References 0 publications

SAPS 3 admission score: an external validation in a general intensive care population

SAPS 3 admission score: an external validation in a general intensive care population

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

Choice of Optimal Time and Type of Orthopedic Surgery in Multiple Injured Patients with Acute Respiratory Distress Syndrome (ARDS) Depending on Age: Retrospective Study

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