Mortality discrimination in acute myocardial infarction: comparison between APACHE III and SAPS II prognosis systems

Reina, A; Vázquez, Guillermo; Aguayo, Eduardo; Bravo, Iside; Colmenero, Manuel; Bravo, Manuel

doi:10.1007/s001340050335

Cited by 29 publications

(17 citation statements)

References 13 publications

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“…Patients with acute myocardial infarction had a hospital mortality of 15.6 %. This is in the range of earlier reports with mortality figures from 13 % [15] to 16 % [8].…”

Section: Discussionsupporting

confidence: 72%

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The ability of the Simplified Acute Physiology Score (SAPS II) to predict outcome in coronary care patients

Schuster

Ritschel

et al. 1997

Intensive Care Medicine

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“…Patients with acute myocardial infarction had a hospital mortality of 15.6 %. This is in the range of earlier reports with mortality figures from 13 % [15] to 16 % [8].…”

Section: Discussionsupporting

confidence: 72%

“…Reina et al [15] investigated the recent versions of both scores (APACHE III, SAPS II) in a prospective multicenter study of 1711 patients with acute myocardial infarction. They calculated severity, specificity, and accuracy or mortality discrimination.…”

Section: Discussionmentioning

confidence: 99%

The ability of the Simplified Acute Physiology Score (SAPS II) to predict outcome in coronary care patients

Schuster

Ritschel

et al. 1997

Intensive Care Medicine

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“…In contrast to our study, Reina et al [35] showed much low er mean values on admission for SAPS II in survivors and nonsurvivors (33.3 and 49.2, respectively). This demonstrates the difference between AMI and AMI leading to CS and also the high mortality of CS.…”

Section: Scoring In Cardiogenic Shockcontrasting

confidence: 99%

“…Knaus et al [23] studied 17,740 patients and showed an AUC of 0.90 on admission and an aver age admission score of 50 points for the APACHE III. In a study by Reina et al [35] of 1,711 patients with AMI, the AUC was 0.84 with a sensitivity of 75.80 and a specificity of 75.90. In 2001, Markgraf and coworkers [26] showed an AUC of 0.846 for APACHE III in 1,772 interdiscipli nary ICU patients.…”

Section: Scoring In Cardiogenic Shockmentioning

confidence: 92%

Predictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI

Kellner

Prondzinsky

Pallmann

et al. 2013

Med Klin Intensivmed Notfmed

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Acute myocardial infarction (AMI) is complicated by cardiogenic shock (CS) in 7-10% of cases and the mortality rate is about 60-70% [13,16]. Early revascula rization by percutaneous coronary inter vention (PCI) and intensive care includ ing positive inotropic agents, vasopres sors, and circulatory assist devices are routinely used to improve cardiac output and to prevent multiorgan failure [1,5,16]. Intraaortic balloon pump (IABP) is a commonly used mechanical support sys tem for patients with CS [25,33]. Despite intensive therapy, these patients often de velop a systemic inflammatory response syndrome (SIRS) progressing to multiple organ dysfunction syndrome (MODS) and subsequent death due to multiple or gan failure [6,39]. Identification of these patients in the ICU is clinically important [34]. Previous studies of patients with MODS or sepsis have shown the rele vance of several scoring systems such as the APACHE II [22,42,43] Originalien culation is more complex and laborious. However, a scoring system is only valid for a special group of patients when it has been validated on this group. The objec tive of the present study was to evaluate the predictive value of the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scores on mortality, determined on the day of diagnosis/admission of infarctionrelated CS patients and at the point of maximum value. Methods Inclusion and exclusion criteriaPatients treated with primary PCI for CS secondary to AMI, who required inotro pic and/or vasopressor support despite appropriate volume filling, were includ ed in the study. For the diagnosis of CS, the definitions of Hochman et al. [16] and Reynolds et al. [36] were used. The inclu sion and exclusion criteria are shown in . Tab. 1. Study designIn this prospective observational study, carried out in a medical intensive care unit of a university hospital from 2004 to 2005, we consecutively enrolled 45 pa tients in CS. Patients underwent regu lar clinical assessment, complete inva sive monitoring, and frequent blood sam pling for laboratory markers. Datasets for the APACHE II, APACHE III, ElebuteStoner, SOFA, and SAPS II scores and for the patient parameters were calcu lated. Written informed consent was ob tained from all patients or their relatives. The trial was approved by the local eth ics committee. Primary endpointsThe primary endpoint was the value of the initial and the maximum value of the APACHE II, APACHE III, ElebuteStoner, SOFA, and SAPS II scores in pre dicting mortality. Scores were collected at enrollment and then daily for 4 days. Demographic data, admission diagnosis, mechanical ventilation, IABP use, hemo dynamic parameters, survivors, and non survivors were recorded. The APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scores were determined by the worst value found during the initial 24 h after ICU admission and also by the max imum value during the following 96 h.A flowchart of the study is shown in . Fig. 1. Coronary angiography and PCICoronary angiography and PCI were per formed using...

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“…The most frequent causes of admission were acute myocardial infarction and unstable angina (1,757 and 724 patients, respectively); COPD was the cause of admission for 508 patients, although more patients (742 of the 8,685 total) presented with COPD. This project studied the characteristics (severity, diagnosis, resource consumption, and QOL) of patients admitted to ICUs in Spain and has given rise to published articles addressing the evaluation and Spanish adaptation of the APACHE III in Spain (27,28), comparison of the APACHE III and the Simplified Acute Physiology Score (SAPS II) systems in acute myocardial infarction (29), correlation between the Therapeutic Intervention Scoring System (TISS) and TISS 28 (30), study of therapeutic activity by patient age (31), validation of a specific QOL questionnaire for critical care patients (14), and assessment of QOL of patients before ICU admission and its influence on hospital mortality (15).…”

Section: Methodsmentioning

confidence: 99%

Six-year mortality and quality of life in critically ill patients with chronic obstructive pulmonary disease

Rivera-Fernández

Navarrete-Navarro

Fernández-Mondéjar

et al. 2006

Critical Care Medicine

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Mortality discrimination in acute myocardial infarction: comparison between APACHE III and SAPS II prognosis systems

Abstract: The results indicate good discrimination by the three tests. APACHE III probability shows a statistically significant improvement in accuracy and specificity when compared with the two scores.

Cited by 29 publications

References 13 publications

The ability of the Simplified Acute Physiology Score (SAPS II) to predict outcome in coronary care patients

The ability of the Simplified Acute Physiology Score (SAPS II) to predict outcome in coronary care patients

Predictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI

Six-year mortality and quality of life in critically ill patients with chronic obstructive pulmonary disease

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