Comparison of acute physiology and chronic health evaluation II and simplified acute physiology score II in predicting mortality in intensive care unit

Scoring systems have been developed to predict outcomes in the critical patients and to facilitate the decision making and resource allocation for management of such patients.

The aim of this study was to compare Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in predicting hospital mortality of intensive care unit patients.

This cross-sectional study was conducted on 88 patients admitted to the intensive care unit because of trauma or surgery in Shahid Rajaee hospital، Qazvin 2008. During the first 24 hours of admission، the results of clinical examination and biochemical assays and demographic information were collected to complete each of the scoring systems. Observed mortality and predicted mortality were recorded and compared. Detection value of scoring systems was assessed by Receiver Operating Characteristic (ROC) curves and data were analyzed using logistic regression analysis and Chi-Square test.

M ean age of patients was 44. 25 ± 23. 09 years (2 to 86 years). Observed mortality in ICU was 32. 5% and predicted mortalities were 23. 63±24. 2% and 19. 88±15. 1% according to SAPS II and APACHE II، respectively. There was positive significant correlation between SAPS II and APACHE II scoring systems and between these two scoring systems and observed mortality. There was also positive significant correlation between SAPS II and APACHE II values and GCS score. Area under the ROC curve (AUC) of APACHE II was greater than SAPS II for predicting observed mortality (0. 823 vs. 0. 790).

With regards to the results، both APACHE II and SAPS II scoring systems can be used to predict mortality of intensive care unit patients، but not to help in definite decision-making.