BackgroundThe aim of this study was to determine which of the most commonly used scoring systems for evaluation of critically ill patients in the ICU is the best and simplest to use in our hospital.Material/MethodsThis prospective study included 60 critically ill patients. After admittance to the ICU, APACHE II, SAPS II, and MPM II0 were calculated. During further treatment in the ICU, SOFA and MPM II were calculated at 24 h, 48 h, and 72 h and 7 days after admittance using laboratory and radiological measures.ResultsIn comparison with survivors, non-survivors were older (p<0.01) and spent significantly more days on mechanical ventilation (p<0.01). ARDS was significantly more common in patients who survived compared to those who did not (chi-square=7.02, p<0.01), which is not the case with sepsis (chi-square=0.388, p=0.53). AUROC SAPS II was 0.690, and is only slightly higher than the other 2 AUROC incipient scoring systems, MPM II and APACHE II (0.654 and 0.623). The APACHE II has the highest specificity (81.8%) and MPM II the highest sensitivity (85.2%). MPM II7day AUROC (1.0) shows the best discrimination between patients who survived and those who did not. MPM II48 (0.836), SOFA72 (0.821) and MPM II72 (0.817) also had good discrimination scores.ConclusionsAPACHE II and SAPS II measured on admission to the ICU were significant predictors of complications. MPM II7day has the best discriminatory power, followed by SOFA7day and MPM II48. MPM II7day has the best calibration followed by SOFA7day and APACHE II.

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The occurrence of cardiac arrest during anesthesia and surgery is nowadays associated with many challenges imposed by 21st century medicine. On the one hand, good education of healthcare practitioners, sophisticated anesthetic techniques and equipment, along with safer anesthetics and improved surgical techniques have significantly reduced the risk of cardiac arrest during the perioperative period. Still, the introduction of new, invasive diagnostic and therapeutic procedures in the aging patients and those with comorbidities carries along new risk and challenges. Epidemiological data indicate that intraoperative cardiac arrest is an extremely rare event. Due to variety of moral and ethical prejudices, intraoperative cardiac arrest is frequently presented as if it has happened in the immediate postoperative period, following surgery and anesthesia. The preventive measures, the etiology and diagnosis of cardiac arrest, as well as the specificities regarding organization and performance of cardiopulmonary resuscitation in the operating room, result in a better prognosis compared to other hospital departments. The article also describes the specifics of cardiopulmonary resuscitation in the catheterization laboratory, while a separate section is dedicated to cardiopulmonary resuscitation following systemic toxicity of local anesthetics. Since intraoperative cardiac arrest and death represent very rare complications, European Resuscitation Council has only recently published Guidelines for Resuscitation for performing cardiopulmonary resuscitation in the operating room ? in 2015.