Acute and Critical Care

Original Articles

Trauma
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: Min A Lee, Kang Kook Choi, Byungchul Yu, Jae Jeong Park, Youngeun Park, Jihun Gwak, Jungnam Lee, Yang Bin Jeon, Dae Sung Ma, Gil Jae Lee; Korean J Crit Care Med. 2017;32(4):340-346. Published online November 30, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00255

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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.

Citations

Citations to this article as recorded by

Cell-free DNA as diagnostic and prognostic biomarkers for adult sepsis: a systematic review and meta-analysis
Awirut Charoensappakit, Kritsanawan Sae-khow, Pongpera Rattanaliam, Nuntanuj Vutthikraivit, Monvasi Pecheenbuvan, Suwasin Udomkarnjananun, Asada leelahavanichkul
Scientific Reports.2023;[Epub] CrossRef
Evaluation of the sequential organ failure assessment score and newly introduced criteria – Traumasis - in traffic collision patients
Sion Jo, Taeoh Jeong, Boyoung Park
The American Journal of Emergency Medicine.2022; 51: 98. CrossRef
Predictive value of Modified Early Warning Score (MEWS) and Revised Trauma Score (RTS) for the short-term prognosis of emergency trauma patients: a retrospective study
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BMJ Open.2021; 11(3): e041882. CrossRef
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Joseph D. Bozzay, Patrick F. Walker, David W. Schechtman, Faraz Shaikh, Laveta Stewart, M. Leigh Carson, David R. Tribble, Carlos J. Rodriguez, Matthew J. Bradley
Journal of Trauma and Acute Care Surgery.2021; 91(2S): S247. CrossRef

The Analysis of Prognostic Factors in Patients with Decompensated Liver Cirrhosis Admitted to the Medical Intensive Care Unit: Gil Jae Lee, Jung Nam Lee, Iris Naheah Kim, Keon Kuk Kim, Woon Kee Lee, Jeong Heum Baek, Sang Tae Choi, Won Suk Lee, Byung Chul Yu, Yeon Jeong Park; Korean J Crit Care Med. 2013;28(2):101-107.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.101

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Abstract PDF: BACKGROUND
Patients with decompensated liver cirrhosis usually resulted in admission to the intensive care unit (ICU) during hospitalization. When admitted to the ICU, the mortality was high. The aim of this study is to identify multiple prognostic factors for mortality and to analyze the significance of prognostic survival model with each scoring system in patients with decompensated liver cirrhosis who was admitted to the ICU.
METHODS
From January 2008 to December 2008, 60 consecutive patients with decompensated liver cirrhosis were admitted in the ICU and retrospectively reviewed. Prognostic models used were Child-Turcotte-Pugh (CTP), model for end-stage liver disease (MELD), model for end-stage liver disease with incorporation of serum sodium (MELD-Na), acute physiology and chronic health evaluation (APACHE) II, and sequential organ failure assessment (SOFA). The predictive prognosis was analyzed using the area under the receiver's operating characteristics curve (AUC).
RESULTS
The median follow up period was 20 months, and ICU mortality was 17% (n = 10). A total of 24 patients (40%) died during the study period. The average survival of five prognostic models was related with the severity of the disease. All of the five systems showed significant differences in the cumulative survival rate, according to the scores on admission, and the MELD-Na had the highest AUC (0.924). Multivariate analysis showed that bilirubin and albumin were significantly related to mortality.
CONCLUSIONS
The CPT, MELD, MELD-Na, APACHE II, and SOFA may predict the prognosis of patients with decompensated liver cirrhosis. The MELD-Na could be a better prognostic predictor than other scoring systems.

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