Apache II as a predictive tool of intubation length in critical care unit patients

There are some areas of uncertainty when it comes to determine how long a patient is going to require assisted ventilation. Our study uses Acute Physiologic and Chronic Health Evaluation (APACHE II) score to determine how many days a patient might require assisted ventilation.

All patients admitted to the Cardiac Critical Care unit and Intensive Care Units at Damas Hospital who were placed on mechanical ventilation were evaluated. Patients were evaluated from December 2003 to March 2004. During evaluation, the patient record was reviewed to obtain APACHE II score prior to mechanical ventilation placement. Exclusion criteria were patients who were not evaluated in the first 24 hrs. of admission.

11 patients were examined. Patients that had less than 3 day intubation (mean 2.4 days +/- .54) had lower APACHE II (mean 21.20). Patient with intubation longer than 3 days (mean 14.7 +/- 10.25) had higher APACHE II score (mean 27.5).

Based in our aims, general as well as specific, we conclude that lower APS do correlate with lower intubation days. Working on this data, with APACHE we could predict length of intubation and preventive actions. We think that APACHE II scoring system can be used as a prognostic factor to be discussed with family members and can also be added to current weaning indexes to predict weaning success. We recommend that APACHE II be calculated to every admitted patient to the Critical Care Units and that it should be added to weaning indexes to predict probability of extubation. We recommend a follow-up of this study with a wider population.