Comparison of APACHE II and three abbreviated APACHE II scores for predicting outcome among emergency trauma patients

Polita, Jorge Roberto; Gómez, J. Miguel Lobato; Friedman, Gilberto; Ribeiro, Sérgio Pinto

doi:10.1590/1806-9282.60.04.018

Cited by 16 publications

(14 citation statements)

References 19 publications

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“…The APACHE score and the SAPS score are routinely used to assess the severity and prognosis of patients with general critical illness, not just trauma. Although some studies have also assessed the ability of these physiologically-sensitive scoring systems to predict outcome in patients with trauma, the results suggest no signi cant advantage [43][44][45][46][47][48][49][50][51][52]. None of the scoring tools mentioned above are speci c to older trauma patients.…”

Section: Discussionmentioning

confidence: 99%

Change in Age Distribution of the Injuries and Comparison of Different Scoring Tools in Predicting Mortality Among Geriatric Trauma Patients

Jiang¹,

Zheng²,

Zhang³

2020

Preprint

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Purpose: The aim of this study was to describe the age trend of trauma patients and to compare different scoring tools to predict in-hospital mortality in elderly trauma patients.Methods: National Trauma Database (NTDB) in the United States from 2005 to 2015 and the Trauma Register DGU® in German from 1994 to 2012 was searched to describe age change of trauma patients. Then we secondly analyzed the data published in http://datadryad.org/. According to the in-hospital survival status, patients were divided into survival group and non-survival group. Receiver Operating Characteristic Curve (ROC) analysis was used to evaluated the value of ISS (injury severity score); NISS (new injury severity score), APACHE Ⅱ (Acute Physiology and Chronic Health Evaluation Ⅱ), SPAS Ⅱ (simplified acute physiology score Ⅱ) and TRISS (Trauma and Injury Severity Score) in predicting in-hospital mortality among geriatric trauma patients.Results:The analysis of NTDB showed the percentage of geriatric trauma has increased from 0.18 to 0.30, 2005-2015. The analysis of DGU showed the mean age rose from 39.11 in 1993 to 51.10 in 2013, and the percentage of patients aged ≥60 rose from 16.5% to 37.5%. A total of 311 patients aged more than 65 years were secondly analyzed. One hundred and sixty-four (52.73%) patients died in the hospital. ISS, NISS, APACHE, and SAPS in the death group were significantly higher than those in the survival group, but TRISS in the death group was significantly lower than those in the survival group. The AUC of APACHE Ⅱ was 0.715, ISS was 0.807, NISS was 0.850, SPAS Ⅱ was 0.725, and TRISS was 0.828.Conclusion:The increasing number of trauma in the elderly is a challenge for current and future trauma management. Compared with APACHE and SAPS, ISS, NISS and TRISS are more suitable for predicting in-hospital mortality in elderly trauma patients.

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Section: Discussionmentioning

confidence: 99%

Change in Age Distribution of the Injuries and Comparison of Different Scoring Tools in Predicting Mortality Among Geriatric Trauma Patients

Jiang¹,

Zheng²,

Zhang³

2020

Preprint

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“…Entretanto, a descrição da evolução dessas vítimas na SE foi eventualmente mencionada, porém não detalhada. (44,45,46,47,48,49,50) .…”

Section: Tratamento Clínico Específicounclassified

“…O REMS apresenta escore máximo de 26 pontos, sendo valores altos indicativos de mau prognóstico (44,45,46,47,48,49,50) . De acordo com alguns estudos, a pontuação do REMS pode identificar pacientes com alto risco de morrer (escore >13), risco intermediário (escore de 6 a 13) e baixo risco (escore <6) (44,45,46,48,49,50) .…”

Section: Rapid Emergency Medicineunclassified

“…Estudo realizado no Brasil incluiu pacientes traumatizados >12 anos de idade, admitidos por mais de 24 horas no serviço de emergência (50) . Essa pesquisa teve o objetivo de comparar a habilidade do escore APACHE II com três formas abreviadas desse escore -Simplified APACHE II (s-APACHE II), RAPS e REMSpara predizer mortalidade hospitalar em pacientes de trauma no serviço de emergência (50) .…”

Section: Rapid Emergency Medicineunclassified

“…A comparação entre APACHE II e os escores abreviados mostrou que eles são equivalentes para estratificar o risco de mortalidade hospitalar no serviço de emergência e em pacientes traumatizados (50) . (54) .…”

Section: Rapid Emergency Medicineunclassified

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Evolução da vítima com trauma cranioencefálico na sala de emergência

Silva¹

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A trauma‐related survival predictive model of acute respiratory distress syndrome

Tang

Wang

Peng

et al. 2021

Clinical Laboratory Analysis

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Purpose The purpose of this study was to construct and validate a simple model for the prediction of survival in patients with trauma‐related ARDS. Methods This is a single‐center, retrospective cohort study using MIMIC‐III Clinical Database. Results 842 patients were included in this study. 175 (20.8%) died in‐hospital, whereas 215 (25.5%) died within 90 days. The deceased group had higher Acute Physiology Score (APS III), Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score II (SAPS II). In multivariate logistic regression model, independent risk factors for mortality in ARDS patients included age ([odds ratio] OR, 1.035; 95% confidence interval [CI], 1.020–1.049), body mass index (OR, 0.957; 95% CI, 0.926–0.989), red blood cell distribution width (OR, 1.283; 95% CI, 1.141–1.443), hematocrit (OR, 1.055; 95% CI, 1.017–1.095), lactate (OR, 1.226; 95% CI, 1.127–1.334), blood urea nitrogen (OR, 1.025; 95% CI, 1.007–1.044), acute kidney failure (OR, 1.875; 95% CI, 1.188–2.959), sepsis (OR, 1.917; 95% CI, 1.165–3.153), type of admission (emergency vs. elective [OR, 2.822; 95% CI, 1.647–4.837], and urgent vs. elective [OR, 5.156; 95% CI, 1.896–14.027]). The area under the curve (AUC) of the model was 0.826, which was superior than the SAPS II (0.776), APS III (0.718), and SOFA (0.692). In the cross‐validation model, the accuracy of the test set was 0.823, the precision was 0.643, and the AUC was 0.813. Conclusions We established a prediction model using data commonly used in the clinic, which has high accuracy and precision and is worthy of use in clinical practice.

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Comparison of APACHE II and three abbreviated APACHE II scores for predicting outcome among emergency trauma patients

Cited by 16 publications

References 19 publications

Change in Age Distribution of the Injuries and Comparison of Different Scoring Tools in Predicting Mortality Among Geriatric Trauma Patients

Change in Age Distribution of the Injuries and Comparison of Different Scoring Tools in Predicting Mortality Among Geriatric Trauma Patients

Evolução da vítima com trauma cranioencefálico na sala de emergência

A trauma‐related survival predictive model of acute respiratory distress syndrome

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