Discriminatory Performance of APACHE II Score and the Prediction of Mortality within the ICU in Patients with Sepsis Admitted to the ICU.

Abstract

Background: Severity of illness assessment tools are utilized to triage critically-ill patients and provide a valuable inputs to the healthcare provider to decide the type and intensity of treatment or interventions.

Objective: The aim of this study was to evaluate the discriminatory capabilities of Acute Physiology And Chronic Health Evaluation II (APACHE II) score in the prediction of Intensive care units (ICUs) mortality among patients with sepsis admitted to the ICU.

Methods: Records of patients with sepsis admitted to ICUs were retrospectively reviewed. Discriminatory performance of APACHE II score was assessed by using the receiver operating characteristic's (ROC's) area under the curve (AUC).

Results: The mean±SD of APACHE II score was 27.1±8.4. APACHE II score demonstrated a very good discriminatory performance with an accuracy rate of 75% and an AUC-ROC 0.80 (95%CI: 0.74 - 0.85) at an optimal cutoff of 26. APACHE II score was found to be correlated with ICU mortality with a correlation coefficient of (0.52). ICU mortality was significantly higher in patients with APACHE II score ≥26.

Conclusion: This study revealed that the discriminatory performance of APACHE II score in predicting ICU mortality in patient with sepsis was very good. These findings can have potential clinical implications in the identification and management of patients with sepsis admitted to the ICU.