ICU discharge APACHE II scores help to predict post-ICU death

Area of Science:

• Critical Care Medicine
• Health Outcomes Research

Background:

• Post-intensive care unit (ICU) mortality remains a significant challenge, with rates ranging from 8.6% to 23.6% over the last 15 years.
• Understanding factors influencing mortality after ICU discharge is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the impact of illness severity at ICU discharge, as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score, on post-ICU mortality.
• To identify independent risk factors for death after patients leave the ICU.

Main Methods:

• A 6-month prospective observational study was conducted in a university-affiliated tertiary care hospital's medical ICU.
• Logistic regression analysis was used to identify risk factors for post-ICU mortality.

Main Results:

• Of 203 patients discharged from the ICU, 39 (19.2%) died during hospitalization.
• Higher APACHE II scores at ICU discharge (OR 1.17) and male gender (OR 3.24) were independent predictors of post-ICU mortality.
• Patients with an APACHE II score of 17 or greater at discharge had a 37.3% mortality rate, compared to 9.4% for those with scores below 17.

Conclusions:

• Elevated APACHE II scores upon ICU discharge and male sex are significant risk factors for post-ICU mortality.
• Identifying patients with discharge APACHE II scores of 17 or higher can aid in predicting and potentially mitigating post-ICU deaths.