[Prognostic evaluation of results after intensive therapy based on APACHE III in surgical and non-surgical patients]

The objective of the presented studies was the assessment of survival and death prediction by APACHE III system in surgical and non-surgical patients treated in an intensive therapy unit. The investigated group included 410 patients examined by the APACHE III during the first 24 hours after admission to the multiprofile ITU in the years 1995-1997. The APACHE III system was used on the basis of an agreement with the APACHE Medical System INC. The clinical value of the applied system was assessed by the statistics of logistic regression. In the group of 410 ITU patients, 263 (64.1%) survived and 147 (35.9%) died. The death rate in the surgical group was 27.3%. The major non-surgical group (333--81.2%) showed a death rate of 37.8%. The precision of predictions on the basis of APACHE III was 75.9% with the assumption that the probability of death risk in each patient was 0.5 and more. For the whole studied group system showed an area under ROC equal to 0.830 in 95% of the confidence interval. In the group of surgical patients, the APACHE III system showed a goodness of fit on the basis of Hosmer's and Lemenshow's test and the highest total percentage (81.8%) of correct classification and high value of the ROC = 0.868. The APACHE III system is a good and correct outcome prediction tool for adult patients in a multiprofile ITU. The comparison of the surgical and non-surgical groups of patients showed a better agreement and correctness of the intensive therapy outcomes predictions in the surgical group.