Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit

Berger, Mette M.; Marazzi, Alfio; Freeman, Joel B.; Chioléro, René

doi:10.1097/00003246-199212000-00014

Cited by 57 publications

(41 citation statements)

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“…On the contrary, it was somehow unexpected that APACHE II score did not prove to be predictive of mortality in US patients. Although the mean APACHE II score in our study (12.7 AE 2.8) is in accordance with that reported in previous studies (Bernstein and Offenbartl, 1991;Berger et al, 1992;Goffi et al, 1999;Koperna et al, 2001), the narrow range of APACHE II scores of our sample (7-23) might have reduced the ability to detect a predictive role.…”

Section: Discussionsupporting

confidence: 89%

“…As it was expected, mortality rate was remarkably higher among patients who underwent US, than in patients who received ES. US is by itself a well-defined predictor of mortality at any age (Hosking et al, 1989;Berger et al, 1992;Bufalari et al, 1996;ElHaddawi et al, 2002;Arenal and Bengoechea-Beeby, 2003). This study differs from other studies of mortality in surgical older patients in that it aimed to investigate predictors of mortality among a wide series of variables, including conventional scores (ASA and APACHE II), anamnestic and clinical variables, measures of functional and cognitive status, and presence and severity of comorbid illnesses.…”

Section: Discussionmentioning

confidence: 99%

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Predictive factors of clinical outcome in older surgical patients

Cacello

Ghiggia

et al. 2007

Archives of Gerontology and Geriatrics

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We aimed to identify predictors of mortality and length of stay-in hospital in older surgical patients. In 294 patients (mean age 74.1 AE 6.4 years, 153 men), consecutively admitted to four surgery units of a university-teaching hospital to receive elective surgery (ES, 56.5%) or urgent surgery (US, 43.5%), the following variables were evaluated: demographics, clinical history (hypertension, diabetes mellitus (DM), coronary heart disease (CHD), heart failure (HF), cerebrovascular accidents, chronic obstructive pulmonary disease (COPD), active neoplasm, cognitive impairment, immobilization, pressure ulcers), physiopathology (Acute Physiology and Chronic Health Evaluation, APACHE, II), cognition/function (Short Portable Mental Status Questionnaire, SPMSQ; activity of daily living, ADL; instrumental activity of daily living, IADL), comorbidity (Cumulative Illness Rating Scale, CIRS, 1 and 2) and anesthesiology (American Score Anesthesiologist, ASA). The vital status of the patient at 1 month after discharge and the duration of hospitalization were recorded. One-month mortality rate was 6.1%. Low hemoglobin and body mass index (BMI) values, increasing ASA score, and, only in US patients, ADL dependence and higher CIRS 1 score, were independently predictive of mortality. Low hemoglobin levels and, only in ES patients, higher CIRS 1 score were associated with prolonged hospitalization. Prognostic indicators specific to older people have limited value in mortality models in elderly surgical patients. #

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Predictive factors of clinical outcome in older surgical patients

Cacello

Ghiggia

et al. 2007

Archives of Gerontology and Geriatrics

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“…In the control group, ASA physical status was routinely assessed prior to the surgery. Disease severity scores, Acute Physiology and Chronic Health Evaluation II (APACHE II) (Berger et al 1992) and Sequential Organ Failure Assessment (SOFA) (Moreno et al 1999), were calculated daily, at the time of sample collection. Modification of Diet in Renal Disease (MDRD) formula was used to calculate glomerular filtration rate (GFR) (Levey et al 1999).…”

Section: Clinical Assessmentmentioning

confidence: 99%

Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury

Bojić

Kotur‐Stevuljević

Kalezić

et al. 2015

Tohoku J. Exp. Med.

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Sepsis-associated acute kidney injury (SA-AKI) severely impacts morbidity and mortality in surgical patients with sepsis. Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) have an important role in pathophysiology of sepsis but they have been unexplored in SA-AKI. We aimed to investigate the role of MMP-9 and TIMP-1 in septic surgical patients with SA-AKI and to evaluate them as diagnostic biomarkers of SA-AKI. This prospective observational study compared 53 major abdominal surgery patients with sepsis divided into SA-AKI (n = 37) and non-SA-AKI (n =16) group to 50 controls without sepsis matched by age, gender, comorbidities and type of surgery. Blood and urine samples from septic patients were collected on admission to ICU and 24, 48, 72 and 96 h later and once from the controls. The levels of MMP-9, TIMP-1, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, urea and creatinine were measured. MMP-9/TIMP-1 ratio and disease severity scores, such as Sequential Organ Failure Assessment (SOFA), were calculated. Septic patients with SA-AKI had higher serum TIMP-1 levels and lower serum MMP-9 levels and lower MMP-9/TIMP ratio, compared to septic patients without SA-AKI and controls. The levels of these biomarkers did not change significantly over time. MMP-9, TIMP-1 and MMP-9/TIMP-1 ratio correlated with urea, creatinine, NGAL, and SOFA scores. Moreover, using the area under ROC curve, we showed that TIMP-1 and MMP-9/TIMP-1 ratio, but not MMP-9, were good diagnostic biomarkers of SA-AKI. We report for the first time the potential diagnostic value of TIMP-1 and MMP-9/TIMP-1 ratio in SA-AKI.Keywords: acute kidney injury; biomarker; matrix metalloproteinase-9; sepsis; tissue inhibitor of matrix metalloproteinase-1 Tohoku

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“…To evaluate sedation frequency, the records of 492 patients were retrospectively studied to identify those receiving sedative drugs. Exclusion criteria were patients remaining in the ICU for less than 24 hours and those without documented exams for severity index calculation and APACHE II prognosis 14 . The sample was reduced to 307 patients who were divided in two groups: non-sedated group (NSG), with patients not receiving any type of sedatives (n = 192); and sedated group (SG), with patients who were sedated while admitted (n = 115).…”

Section: Methodsmentioning

confidence: 99%

“…The sample was reduced to 307 patients who were divided in two groups: non-sedated group (NSG), with patients not receiving any type of sedatives (n = 192); and sedated group (SG), with patients who were sedated while admitted (n = 115). Both groups were compared as to gender, age and initial severity according to APACHE II index 14 . Non-parametric tests were used for statistical analysis of results, taking into account the nature of studied variables.…”

Section: Methodsmentioning

confidence: 99%

Experiência clínica com o uso de sedativos em terapia intensiva: estudo retrospectivo

Júnior¹,

Amaral

2002

Rev. Bras. Anestesiol.

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Justificativa e Objetivos Background and Objectives -Among the most frequent indications for Intensive Care Unit patients sedation, one may mention artificial ventilation installation and maintenance, anxiety and uncomfortable or painful procedures. This retrospective study aimed at evaluating most common sedation indications and techniques for severe patients admitted to the Surgical Int e n s i v e C a r e U n i t , E s c o l a P a u l i s t a d e M e d i c i n a (EPM/UNIFESP) during an 11-month period. Methods -After excluding patients remaining in the ICU for less than 24 hours and those without the necessary evaluation to determine their severity index (APACHE II)

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Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit

Cited by 57 publications

References 0 publications

Predictive factors of clinical outcome in older surgical patients

Predictive factors of clinical outcome in older surgical patients

Diagnostic Value of Matrix Metalloproteinase-9 and Tissue Inhibitor of Matrix Metalloproteinase-1 in Sepsis-Associated Acute Kidney Injury

Experiência clínica com o uso de sedativos em terapia intensiva: estudo retrospectivo

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