Korean J Crit Care Med.  2017 Nov;32(4):340-346. 10.4266/kjccm.2017.00255.

Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit

• Lee MA
• Choi KK
• Yu B
• Park JJ
• Park Y
• Gwak J
• Lee J
• Jeon YB
• Ma DS
• Lee GJ

• KMID: 2405120
• DOI: http://doi.org/10.4266/kjccm.2017.00255

Abstract

BACKGROUND
The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU).
METHODS
We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated.
RESULTS
The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher.
CONCLUSIONS
In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.

Keyword

APACHE II; intensive care units; mortality; multiple trauma; Sequential Organ Failure Assessment

MeSH Terms

APACHE*
Cardiovascular System
Complement System Proteins
Critical Care*
Critical Illness
Humans
Injury Severity Score
Intensive Care Units*
Mortality
Multiple Trauma
Retrospective Studies
Survival Rate
Trauma Centers
Complement System Proteins

Figure

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  Figure 1. Receiver operating characteristic (ROC) curves for APACHE II, SOFA (mean), TRISS, and ISS. SOFA: Sequential Organ Failure Assessment; APACHE: Acute Physiology and Chronic Health Evaluation; ISS: Injury Severity score; TRISS: Trauma and Injury Severity score.

Reference

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