Comparison of the Predictive Power of the LODS and APACHE II Scoring Systems in a Neurological Intensive Care Unit

Kim, T K; Yoon, Jun Rho

doi:10.1177/147323001204000244

Cited by 13 publications

(6 citation statements)

References 33 publications

(29 reference statements)

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“…Another prospective study by Kim and Yoon in 521 consecutive patients admitted to the neurological ICU, showed that both the LODS and the APACHE II score had excellent discrimination but LODS had superior calibration; they therefore, concluded that the LODS was more stable than the APACHE II scoring system in the neurological ICU setting. [30] However, Maccariello et al . [7] evaluated the performance of LODS in patients receiving renal replacement therapy and found poor correlation between LODS score and predicted mortality rate.…”

Section: Types Of Icu Scoring Systemsmentioning

confidence: 99%

Scoring systems in the intensive care unit: A compendium

Rapsang¹,

Shyam²

2014

Indian Journal of Critical Care Medicine

185

136

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Severity scales are important adjuncts of treatment in the intensive care unit (ICU) in order to predict patient outcome, comparing quality-of-care and stratification for clinical trials. Even though disease severity scores are not the key elements of treatment, they are however, an essential part of improvement in clinical decisions and in identifying patients with unexpected outcomes. Prediction models do face many challenges, but, proper application of these models helps in decision making at the right time and in decreasing hospital cost. In fact, they have become a necessary tool to describe ICU populations and to explain differences in mortality. However, it is also important to note that the choice of the severity score scale, index, or model should accurately match the event, setting or application; as mis-application, of such systems can lead to wastage of time, increased cost, unwarranted extrapolations and poor science. This article provides a brief overview of ICU severity scales (along with their predicted death/survival rate calculations) developed over the last 3 decades including several of them which has been revised accordingly.

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Section: Types Of Icu Scoring Systemsmentioning

confidence: 99%

Scoring systems in the intensive care unit: A compendium

Rapsang¹,

Shyam²

2014

Indian Journal of Critical Care Medicine

185

136

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“…The APACHE II scoring system is now widely applied for evaluating the severity of illness and the prognosis of ICU patients. However, the score is somewhat related to the management in ICU because the worst score within 24 h rather than the score upon admission is required (Ho et al, 2006), and it is not stable for evaluating the severity of illness and the prognosis of neonatal intensive care patients (Kim and Yoon, 2012). Therefore, its application in this study has some limitations.…”

Section: Discussionmentioning

confidence: 97%

Values for serum procalcitonin, C-reactive protein, and soluble triggering receptor expressed on myeloid cells-1 in predicting survival of patients with early-onset stroke-associated pneumonia

Xie¹,

Zhang²,

Zhu³

2015

Genet. Mol. Res.

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ABSTRACT. We examined the value of serum procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for predicting the survival of patients with early-onset stroke associated pneumonia (EOP). A total of 207 stroke patients were enrolled, and 91 developed EOP. Upon admission, serum PCT, CRP, sTREM-1 levels, clinical pulmonary infection score, and Acute Physiology and Chronic Health Evaluation II score were all significantly higher in patients with EOP than in those without EOP (P < 0.05). Of the 91 patients who developed EOP, 39 (42.9%) died (non-survivors) within 28 days. The Acute Physiology and Chronic Health Evaluation II score on admission was significantly higher in non-survivors than in survivors (P < 0.05). Serum PCT and sTREM-1 levels were slightly elevated on days 1, 3, and 5 in non-survivors and gradually decreased in survivors. Serum PCT, sTREM-1, and CRP levels were all significantly higher in non-survivors than in survivors on days 1, 3, and 5 (P < 0.05). The sensitivity and specificity of PCT for predicting the outcome of EOP were 84.6 and 71.2%, the sensitivity and specificity of sTREM-1 were 71.8 and 92.3%, and the sensitivity and specificity of sTREM-1 combined with PCT were 74.4 and 96.2%. Serum PCT combined with sTREM-1 accurately predicted the outcome of EOP patients, and dynamic monitoring of serum PCT and sTREM-1 levels is necessary.

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“…Six sub-score ranged from 0–5 for LODS, developed by Le Gall et al in 1996 [ 30 ]. Previous prediction of outcomes in neurological ICU patients have shown that LODS has more stability than APACHE II [ 31 ]. However, we found that our nomogram was more superior to the LODS score, which accounts for the largest proportion of the nervous system.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram for predicting 28-day mortality in patients with ischemic stroke

Fang,

Zhou,

Mao

et al. 2024

PLoS ONE

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Background/aim We aimed to construct a validated nomogram model for predicting short-term (28-day) ischemic stroke mortality among critically ill populations. Materials and methods We collected raw data from the Medical Information Mart for Intensive Care IV database, a comprehensive repository renowned for its depth and breadth in critical care information. Subsequently, a rigorous analytical framework was employed, incorporating a 10-fold cross-validation procedure to ensure robustness and reliability. Leveraging advanced statistical methodologies, specifically the least absolute shrinkage and selection operator regression, variables pertinent to 28-day mortality in ischemic stroke were meticulously screened. Next, binary logistic regression was utilized to establish nomogram, then applied concordance index to evaluate discrimination of the prediction models. Predictive performance of the nomogram was assessed by integrated discrimination improvement (IDI) and net reclassification index (NRI). Additionally, we generated calibration curves to assess calibrating ability. Finally, we evaluated the nomogram’s net clinical benefit using decision curve analysis (DCA), in comparison with scoring systems clinically applied under common conditions. Results A total of 2089 individuals were identified and assigned into training (n = 1443) or validation (n = 646) cohorts. Various identified risk factors, including age, ethnicity, marital status, underlying metastatic solid tumor, Charlson comorbidity index, heart rate, Glasgow coma scale, glucose concentrations, white blood cells, sodium concentrations, potassium concentrations, mechanical ventilation, use of heparin and mannitol, were associated with short-term (28-day) mortality in ischemic stroke individuals. A concordance index of 0.834 was obtained in the training dataset, indicating that our nomogram had good discriminating ability. Results of IDI and NRI in both cohorts proved that our nomogram had positive improvement of predictive performance, compared to other scoring systems. The actual and predicted incidence of mortality showed favorable concordance on calibration curves (P > 0.05). DCA curves revealed that, compared with scoring systems clinically used under common conditions, the constructed nomogram yielded a greater net clinical benefit. Conclusions Utilizing a comprehensive array of fourteen readily accessible variables, a prognostic nomogram was meticulously formulated and rigorously validated to provide precise prognostication of short-term mortality within the ischemic stroke cohort.

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Comparison of the Predictive Power of the LODS and APACHE II Scoring Systems in a Neurological Intensive Care Unit

Cited by 13 publications

References 33 publications

Scoring systems in the intensive care unit: A compendium

Scoring systems in the intensive care unit: A compendium

Values for serum procalcitonin, C-reactive protein, and soluble triggering receptor expressed on myeloid cells-1 in predicting survival of patients with early-onset stroke-associated pneumonia

Development and validation of a nomogram for predicting 28-day mortality in patients with ischemic stroke

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