The value of APACHE II in predicting mortality after paraquat poisoning in Chinese and Korean population

Abstract

Background:The Acute Physiology and Chronic Health Evaluation II (APACHE II) score is used to determine disease severity and predict outcomes in critically ill patients. However, the prognostic significance of APACHE after acute paraquat (PQ) poisoning remains unclear. The meta-analysis was aimed to study the value of APACHE II in predicting mortality in PQ-exposed Chinese and Korean patients.Methods:Databases that included PubMed, Embase, Cochrane Library, and the Chinese National Knowledge Infrastructure were searched through August 2016. Studies using APACHE II to predict mortality in PQ-poisoned patients were selected. The odds ratio and weighted mean difference (WMD) were used to pool binary and continuous data. Additionally, we aggregated sensitivity, specificity, and other measures of accuracy. Statistical analyses were made using the Stata V.13.0 software.Results:This study included 29 studies, and 25 studies evaluated APACHE II scores on admission. Pooled data showed that survivors had significantly lower total scores than nonsurvivors (WMD = –7.29, and I2 = 98.2%, both P <.05). The pooled sensitivity of an APACHE II score ≥5 for predicting mortality was 75% and the pooled specificity was 86%. The positive likelihood ratio (PLR) was 5.3 and the negative likelihood ratio (NLR) was 0.29. The pooled sensitivity of an APACHE II score ≥10 for predicting mortality was 88% and the pooled specificity was 84%. The pooled PLR and NLR was 5.5 and 0.15, respectively.Conclusion:This study showed PQ-poisoned nonsurvivors had significantly higher APACHE II score than did survivors. APACHE II scores satisfactorily predicted mortality.

Comparison of the Effectiveness of Acute Physiology and Chronic Health Evaluation II and Modified Early Warning Score Scoring Systems in Predicting Mortality in Patients in the Intensive Care Unit

“…The APACHE II score was found to be useful in predicting mortality in patients with intoxication, urosepsis, and ICU admission (2,8,10,11). Furthermore, high APACHE II scores were found to be associated with prolonged ICU hospitalization (9).…”

“…For an APACHE II score with a low threshold (≥5), the sensitivity and specificity in predicting mortality was 75% and 86%, respectively. In contrast, for an APACHE II score with a high threshold value (≥10), significantly higher sensitivity (84%) and specificity (88%) values were reported (11). Özbilgin et al reported that the sensitivity and specificity of an APACHE II score >13.5 in predicting mortality was 77.5% and 70.9%, respectively (3).…”

Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Surgical Intensive Care Unit

“…The SICU patients had a median baseline SOFA score of 4 (IQR, 3-9) and a median APACHE II score of 16 (IQR,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). A significant cutoff point for SOFA score has not yet been established, although SOFA score cutoffs in predicting mortality are reported to range from 2 to 7.…”

“…[13][14][15] APACHE II score cutoffs of 10-24 are reported to have high sensitivity and specificity in predicting clinical outcomes. [16][17][18] Considering the roles of SOFA and APACHE II scores in determining disease severity, the SICU patients in the present study were regarded as having moderately severe disease.…”

A Novel and Simple Risk Model Predicts the Prognosis for Patients with Paraquat Poisoning

“…To our knowledge, several prognostic score systems have been reported to predict the clinical outcomes of patients with PQ poisoning, the major ones being the Acute Physiology and Chronic Health Evaluation II (APACHE II) score [7], Sequential Organ Failure Assessment (SOFA) score [8], the severity index of PQ poisoning (SIPP) [9], Poisoning Severity Score (PSS) [10] and some equations and nomograms based on large cohort study [11][12][13]. Most of them are more suitable for critically ill patients instead of minimally poisoned or early-stage patients who showed mild symptoms.…”