Assessment and comparison of 3 mortality prediction models SAPS II, APACHE II and SOFA for prediction of mortality in patients of sepsis

Abstract

Background: Little is known about outcomes of patients admitted to the ICU with severe sepsis and septic shock, despite the seriousness of sepsis as a public health problem in developing countries. Understanding sepsis outcome studies is hampered by lack of an agreed severity of illness scoring system for sepsis patients. The objective of the present study is to assess and compare the validity of 3 mortality prediction models SAPS 2, APACHE II and SOFA for prediction of mortality in patients of sepsis.Methods: One hundred patients of Sepsis were selected after applying the inclusion and exclusion criteria. Informed consent was taken from the patients or their relatives A careful and detailed history was recorded to assess the onset and duration of clinical events and the probable risk factors for the same; a detailed general physical examination was performed. Blood sampling for CBC, RFT, LFT and arterial blood gas analysis was done. SAPS 2, APACHE II and SOFA scores were calculated on the day of admission.Results: The ROC analysis shows that the best discrimination was provided by SAPS 2 score (AUROC=0.981), followed by APACHE II (AUROC=0.978) and SOFA (AUROC=0.911).Conclusions: SAPS 2 score was superior to the APACHE II and SOFA scores for predicting survival in patients with septic shock but a combination of factors must be taken in consideration to estimate the prognosis in the ICU.

Comparing APACHE II, APACHE IV, SAPS II, and SOFA Predictive Power in Poisoned Patients Admitted to the Intensive Care Unit

“…In these studies and some other previous reports [11,13], the SOFA score system had the lowest discriminatory power between survived and deceased patients as compared with the three other scoring systems. This result can be attributed to the design of the SOFA scoring system.…”

“…They had calculated the AUROC to be 0.78 for APACHE II, which are similar to our findings. In contrast to these studies, several studies reported that the SAPS II score was superior to the APACHE II score for mortality prediction [13,18]. Regardless of either APACHE II or SAPS II is better, many studies reported no statistically significant difference between APACHE II and SAPS II, and even a good correlation between them [8,12,[19][20][21].…”

Association between comorbid asthma and prognosis of critically ill patients with severe sepsis: a cohort study

“…In addition, it suggests that the potential mechanisms of the protective effect could also be related to the use of medication that led to a well control of symptoms of asthma. Apart from the confounding factors considered in Zein et al’s study 28 , the illness severity score SAPS II was also adjusted in our study, which would greatly increase the strength of our study, since it has been reported to be associated with prognosis of sepsis patients 38 and therefore relieve the concern about potential confounding bias.…”

EVALUATION OF APACHE- IV & SAPS- II SCORING SYSTEMS AND CALCULATION OF STANDARDISED MORTALITY RATE IN SEVERE SEPSIS AND SEPTIC SHOCK PATIENTS- A PROSPECTIVE OBSERVATIONAL STUDY

“…The sensitivity and specificity of both scoring systems in our study were not very satisfactory (SAPS II: 100% sensitivity and 41.67% specificity and APACHE IV: 50% sensitivity and 87.5% specificity) when compared with others. Sharma S et al [23] found SAPS II predicting with 88.23% sensitivity and 100% specificity in sepsis patients. In a Turkish intensive care unit, Ayazoglu T, [21] observed excellent result by APACHE IV on stroke patients (at score >84.5, 94.7% sensitivity and 94.4% specificity).…”