Comparing Acute Physiology and Chronic Health Evaluation (APACHE) IV and Simplified Acute Physiology (SAPA) III Scoring Methods in Predicting Mortality Rate in Patients Admitted to Intensive Care Unit

The prediction of death in intensive care units is done by using scoring systems assess the disease severity. This study was performed to compare two scoring systems, Acute Physiology and Chronic Health Evaluation (APACHE) IV and Simplified Acute Physiology (SAPA) III, in predicting mortality rate in intensive care units (ICU).

In this retrospective cross-sectional study, we calculated 60 patient during the year 2012 admitted to ICU wards in Shahid Rajaei hospital, Qazvin, Iran. APACHE IV and SAPA III scores and predicted mortality were calculated. Then, the real mortality in intensive care units were recorded. Using the area under the curve of receiver operating characteristic (ROC), performance and differentiation of these models to predict mortality were assessed. Data were analyzed using Mann-Whitney test at the significant level of P-value of less than 0.05.

Of 74 patients admitted to the intensive care unit, 60 were included in the study, 38 men and 22 women. The mean age of patients was 59.0 years and the average duration of hospital staying was 12.10 days; 11 patients died. The mean scores of APACHE IV and SAPA III were 30.0 ± 3.4 and 15.0 ± 2.0, respectively. The area under ROC curve was 0.990 for APACHE IV with confidence interval of 0.930 to 1.008 and 0.97 for SAPA III with confidence interval 0.97-1.008with a significant difference (P < 0.001).

Our study revealed that APACHE IV scoring method predicted the mortality rates in intensive care units better than SAPSIII method.