Predicting Survival in Aids Patients with Respiratory Failure: Application of the APACHE II Scoring System

Chu, Daniel Y

doi:10.1016/s0749-0704(18)30209-4

Cited by 29 publications

(10 citation statements)

References 34 publications

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“…This supports previous findings of the predictability of physiologic scores in other critically ill populations 25,43,44 and in patients with AIDS-related PCP and ARF. 23,[32][33][34]38 Our findings also refute the conclusions of Kumar and Krieger, 29 who found CD4 + count to be predictive of in-hospital mortality in ventilated patients. Median albumin level on admission to the ICU was significantly different between patients who survived and those who did not (Table 2), but the difference is not clinically relevant.…”

supporting

confidence: 84%

Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

Forrest¹,

Zala²,

Djurdjev³

et al. 1999

Arch Intern Med

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Objectives: To determine (1) predictors of in-hospital mortality and long-term survival in patients with acute respiratory failure (ARF) caused by acquired immunodeficiency syndrome-related Pneumocystis carinii pneumonia (PCP) and (2) long-term survival for patients with ARF relative to those without ARF.Methods: A retrospective medical chart review was conducted of all cases of PCP-related ARF for which the patient was admitted to the intensive care unit of a single tertiary care institution between 1991 and 1996. Data were extracted regarding physiologic scores, relevant laboratory values, and duration of previous maximal therapy with combined anti-PCP agents and corticosteroids at entry to the intensive care unit. Duration of survival was determined by Kaplan-Meier methods from date of first hospital admission and compared for patients with and without ARF.Results: There were 41 admissions to the intensive care unit among 39 patients, with 56.4% in-hospital mortality. Higher physiologic scores (Acute Physiology and Chronic Health Evaluation II [APACHE II], Acute Lung Injury, and modified Multisystem Organ Failure scores) were predictive of in-hospital mortality. Duration of previous maximal therapy also predicted in-hospital mortality (45% for patients with Ͻ5 days of previous maximal therapy vs 88% for those with Ն5 days of previous maximal therapy; P = .03). Combining physiologic scores and duration of previous maximal therapy enhanced prediction of in-hospital mortality. There was no difference in long-term survival between patients with PCP with ARF and those without ARF (P = .80), and baseline characteristics did not predict long-term survival.Conclusions: In-hospital mortality of patients with acquired immunodeficiency syndrome-related PCP and ARF is predicted by duration of previous maximal therapy and physiologic scores, and their combination enhances predictive accuracy. Long-term survival of patients with ARF caused by PCP is comparable to that of patients with PCP who do not develop ARF, and determinants of in-hospital mortality do not predict longterm survival. Med. 1999;159:741-747 Arch Intern

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supporting

confidence: 84%

Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

Forrest¹,

Zala²,

Djurdjev³

et al. 1999

Arch Intern Med

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“…However, these systems have not always proven valid in specific patient populations such as those with septicemia (7), HIV positive serum (8, 9), Pneumocystis carinii pneumonia (10), cardiac diseases (11) or neoplastic diseases (12, 13). Patients who are admitted to the neurosurgical ICU (NICU) are likely in many instances to have higher mortality despite multimodal intensive management, regardless of their neurosurgical diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in Predicting Hospital Mortality of Neurosurgical Intensive Care Unit Patients

et al. 2009

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We study the predictive power of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in neurosurgical intensive care unit (ICU) patients. Retrospective investigation was conducted on 672 consecutive ICU patients during the last 2 yr. Data were collected during the first 24 hours of admission and analyzed to calculate predicted mortality. Mortality predicted by two systems was compared and, multivariate analyses were then performed for subarachnoid hemorrhage (SAH) and traumatic brain injury (TBI) patients. Observed mortality was 24.8% whereas predicted mortalities were 37.7% and 38.4%, according to APACHE II and SAPS II. Calibration curve was close to the line of perfect prediction. SAPS II was not statistically significant according to a Lemeshow-Hosmer test, but slightly favored by area under the curve (AUC). In SAH patients, SAPS II was an independent predictor for mortality. In TBI patients, both systems had independent prognostic implications. Scoring systems are useful in predicting mortality and measuring performance in neurosurgical ICU setting. TBI patients are more affected by systemic insults than SAH patients, and this discrepancy of predicting mortality in each neurosurgical disease prompts us to develop a more specific scoring system targeted to cerebral dysfunction.

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“…These systems have been constructed in general ICU populations, with mathematical models integrating the most relevant co-variates associated with mortality. However, these systems have not always proven their validity in specific populations, such as septicemic patients, HIV-positive patients admitted to medical ICU or presenting with Pneumocystis carinii pneumonia and cardiac patients [6,8,19,20,22] or patients with neoplastic diseases [4,13]. In a previous study [21], we compared APACHE II and SAPS II in critically ill cancer patients admitted to a specific oncological medical ICU.…”

Section: Introductionmentioning

confidence: 99%

Is a specific oncological scoring system better at predicting the prognosis of cancer patients admitted for an acute medical complication in an intensive care unit than general gravity scores?

Berghmans

Paesmans

Sculier

2004

Supportive Care in Cancer

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Predicting Survival in Aids Patients with Respiratory Failure: Application of the APACHE II Scoring System

Cited by 29 publications

References 34 publications

Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in Predicting Hospital Mortality of Neurosurgical Intensive Care Unit Patients

Is a specific oncological scoring system better at predicting the prognosis of cancer patients admitted for an acute medical complication in an intensive care unit than general gravity scores?

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