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Better prognostic marker in ICU - APACHE II, SOFA or SAP II!
Iftikhar Haider Naqvi1, Khalid Mahmood2, Syed Ziaullaha3
1Dr. Iftikhar Haider Naqvi, MBBS, FCPS. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Pakistan Journal of Medical Sciences
|November 25, 2016
Summary
This study compared scoring systems for critically ill patients. APACHE II, SAP II, and SOFA scores accurately predicted mortality, with APACHE II demonstrating superior calibration and discrimination.
Area of Science:
- Critical Care Medicine
- Prognostic Scoring Systems
- Patient Outcomes
Background:
- Accurate prognosis assessment is vital for critically ill patients.
- Various scoring systems exist to predict mortality in intensive care units.
- Comparative efficacy of these systems requires ongoing evaluation.
Purpose of the Study:
- To compare the prognostic accuracy of APACHE II, SAP II, and SOFA scoring systems.
- To evaluate the calibration and discrimination of these models in a specific patient cohort.
- To determine the most effective scoring system for critically ill patients in the studied setting.
Main Methods:
- Retrospective study of 96 critically ill patients (age >16) admitted to MICU/HDU.
- Calculation of predicted mortality using APACHE II, SAP II, and SOFA scores.
- Assessment of model validity using calibration and discrimination metrics.
Main Results:
- All scoring systems (APACHE II, SAP II, SOFA) showed statistically significant differences between survivors and non-survivors (p<0.001).
- Non-survivors consistently had higher average scores across all three systems.
- APACHE II exhibited better calibration and discrimination compared to SAP II and SOFA.
Conclusions:
- APACHE II, SAP II, and SOFA are sufficiently accurate for general prognostication of ICU patients.
- APACHE II is the preferred scoring system due to its superior performance in calibration and discrimination.
- Findings support the utility of validated scoring systems in critical care decision-making.
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