SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit?

The aim of the present study was to evaluate the effectiveness of the Simplified Acute Physiology Score (SAPS) III and the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the prediction of in-hospital mortality in surviving multi-trauma patients.

This study was conducted in the 13-bed intensive care unit (ICU) of a tertiary hospital. A retrospective review of multi-trauma patients whose care was managed in the ICU was performed. Data collection included details of age, gender, ICU admission, and outcome. APACHE IV and SAPS III scores, as well as the predicted mortality rate (PMR), were calculated using web-based calculators.

Of the 90 patients 20% (n=18) were female and 80% (n=72) were male. The overall mortality rate was 25.6%. The mean APACHE IV, Acute Physiology Score (APS) and SAPS III score was 69.27+-34.51, 66.42+-33.72, and 26.36+-27.14, respectively. The mean PMR according to the APACHE IV and the SAPS III was 26.36+-27.14 and 17.07+-24.88, respectively. The area under the curve result of receiver operating characteristic curve analysis was 0.87 for the APACHE IV and 0.93 for the SAPS III.

The performance of the SAPS III was more sensitive and discriminative than the APACHE IV scoring system for multi-trauma ICU patients.