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APACHE II scoring for predicting outcome in cerebral malaria

P Wilairatana1, S Looareesuwan

  • 1Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

The Journal of Tropical Medicine and Hygiene
|August 1, 1995
PubMed
Summary

The APACHE II score effectively predicts outcomes in cerebral malaria patients, identifying high-risk individuals. This tool aids in stratifying prognosis and improving patient management for this severe disease.

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Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Tropical medicine

Background:

  • Cerebral malaria is a severe complication of Plasmodium falciparum infection, associated with high morbidity and mortality.
  • Accurate prognostic tools are essential for timely intervention and resource allocation in managing cerebral malaria.

Purpose of the Study:

  • To evaluate the utility of the APACHE II (Acute Physiology and Chronic Health Evaluation) scoring system in stratifying the prognosis of adult patients with cerebral malaria.
  • To identify key prognostic factors associated with mortality in this patient cohort.

Main Methods:

  • The APACHE II severity-of-disease classification system was applied to 72 adult patients diagnosed with cerebral malaria.
  • Statistical analysis was performed to determine the accuracy of the APACHE II score in predicting mortality outcomes.

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  • Prognostic factors were identified through comparative analysis.

    • Main Results:

    • The overall mortality rate in the study cohort was 13.89%.
    • An APACHE II score cut-off of 24 demonstrated 95.8% accuracy in stratifying patient mortality.
    • Factors such as a high APACHE II score, deep unconsciousness, acute renal failure, and acidaemia were significantly associated with poor prognosis.

    Conclusions:

    • The APACHE II scoring system is a valuable tool for stratifying prognosis in adult patients with cerebral malaria.
    • Identifying patients with poor prognostic factors allows for targeted management strategies.
    • Further research can explore the integration of APACHE II with other clinical parameters for enhanced predictive accuracy.