Comparison of acute physiology and chronic health evaluation II and Glasgow Coma Score in predicting the outcomes of Post Anesthesia Care Unit′s patients

Hosseini, Mohammad Bagher; Ramazani, Jamileh

doi:10.4103/1658-354x.152839

Cited by 13 publications

(12 citation statements)

References 27 publications

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“…In the eye response component of the FOUR scale, a complete score is awarded only when the patient can blink ondemand or follow a target, which helps make a distinction between the aforementioned states12,22 . Despite all these shortcomings of GCS, Hosseini et al reported that this scale was even better than APACHE II in predicting patient mortality23 . Cho et al stated that although GCS is suitable for assessing early mortality, it is not a good replacement for APACHE, as APACHE II is a better predictor of late mortality24 .…”

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confidence: 99%

The ability of GCS, FOUR, and APACHE II in predicting the outcome of patients with traumatic brain injury: A comparative study

et al. 2020

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Introduction: Assessment of the neurological condition of patients admitted to intensive care units gives healthcare professionals the necessary knowledge to attempt to improve their condition and final outcome. Such an assessment cannot be done without a highly reliable and accurate instrument. This study aimed to compare the ability of GCS and FOUR scales to assess the level of consciousness and dysfunction in patients with traumatic brain injury. Methods: This descriptive cross-sectional study was conducted on 102 patients with traumatic brain injury who were found by convenience sampling. The condition of patients during hospitalization up until determination of the final outcome was assessed using GCS, FOUR, Karnofsky, and APACHE-II scales. In the end, the ability of these scales to predict outcome and dysfunction of these patients, and their correlation in this application, was measured using one-way ANOVA and the Pearson correlation test. Results: Of the 102 patients, 80 (78.4%) were male, and 22 (21.6%) were female. The mean age of patients was 32.214.8. There was a significant correlation between the results of FOUR and GCS in the assessment of the patients' consciousness level (r = 0.925), which was statistically significant (p = 0.0001). The mean scores of FOUR, GCS, and Karnofsky scales were significantly higher in survivors and in patients with neurological deficits than in non-surviving patients. The patients who died also had a significantly higher APACHE-II score than those who did not. FOUR and GCS showed a strong positive correlation in the assessment of outcomes, and both of them also exhibited a high correlation with APACHE II in this respect. Conclusion: GCS and FOUR are both suitable scales for assessing consciousness level and outcome of patients with traumatic brain injury.

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confidence: 99%

The ability of GCS, FOUR, and APACHE II in predicting the outcome of patients with traumatic brain injury: A comparative study

et al. 2020

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“…In a study by Hosseini et al . using a cut‐off score 13·5, The APACHE II score predicted hospital mortality with a sensitivity of 96·6%, a specificity of 62·8% and accuracy of 79·7%, with an area under the ROC curve of 0·857 (Hosseini and Ramazani, ). In another study by Fadaizadeh et al, a total of 415 records of patients admitted during a 1‐year period were retrospectively reviewed.…”

Section: Discussionmentioning

confidence: 99%

Acute Physiology and Chronic Health Evaluation II score for the assessment of mortality prediction in the intensive care unit: a single‐centre study from Iran

Bahtouee

Eghbali

Maleki

et al. 2019

Nursing in Critical Care

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Background: The Acute Physiology and Chronic Health Evaluation (APACHE) II is still commonly used as an index of illness severity in patients admitted to intensive care unit (ICU) and has been validated for many research and clinical audit purposes. Aims and objectives: To investigate the diagnostic value of the APACHE II score for predicting mortality rate of critically ill patients. Design: This was a single-centre, retrospective study of 200 Iranian patients admitted in the medical-surgical adult ICU from June 2012 to May 2013. Methods: Demographic data, pre-existing comorbidities and variables required for calculating the APACHE II score were recorded. Receiver operating characteristic (ROC) curves were constructed, and the area under the ROC curves was calculated to assess the predictive value of the APACHE II score. Results: Of the 200 patients with a mean age of 55⋅27 ± 21⋅59 years enrolled in the study, 112 (54%) were admitted in the medical ICU and 88 (46%) in the surgical ICU. Finally, 116 patients (58%) died, and 84 patients (42%) survived. The overall actual and predicted ICU mortality were 58% and 25⋅16%, respectively. The mean APACHE II score was 16⋅31 in total patients, 17⋅78 in medical ICU and 14⋅45 in surgical ICU patients (P = 0⋅003). Overall, the APACHE II score had the highest prognostic value for predicting the mortality rate of critically ill patients with an area under the cure of 0⋅88, and with a cut-off value of 15, the APACHE II score predicted mortality of patients with a sensitivity of 85⋅3%, a specificity of 77⋅4%, a positive predictive value of 83⋅9% and a negative predictive value of 73⋅9%. Conclusion: This study shows that an APACHE II score of 15 provides the best diagnostic accuracy to predict mortality of critically ill patients. Our observed mortality rate was greater than the predicted death rate, in comparison to the other prestigious centres in the world. Therefore, it appears that we must improve our intensive care to reduce mortality. Relevance to clinical practice: There is a need to create a suitable scoring system to predict the mortality rate of critically ill patients in accordance with the advanced technological equipment and experienced physicians and nurses in that ICU.

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“…To generate risk estimates in accordance with the observed outcomes at different classes of risk, model calibration should be assessed; in other words, calibration power of the model represents the agreement between individual probabilities and actual outcomes. Using the Hosmer-Lemeshow goodness of fit (GOF), P value > 0.05 indicates a well-calibrated model (17). Also, the STROBE checklist was used to guide the reporting of the study.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Predictive Ability of the Pediatric Risk of Mortality III, Pediatric Index of Mortality, and Pediatric Logistic Organ Dysfunction in Medical and Surgical Intensive Care Units

Ramazani

Hosseini

2019

J Compr Ped

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Background:The pediatric risk of mortality (PRISM III), pediatric index of mortality (PIM3), and pediatric logistic organ dysfunction (PELOD-2) are of the most used predictive models in predicting the risk of mortality in the pediatric intensive care unit (PICU). Objectives: The current study aimed at comparing the predictive ability of these three modes in medical/surgical ICUs (MICU/SICU). Methods:A total of 90 consecutive patients, aged ≤ 18 years, admitted to MICUs or SICUs were enrolled in the current observational, prospective study. The PRISM III, PIM3, and PELOD-2 as well as demographic characteristics of the subjects were recorded on admission. A receive operator characteristic (ROC) curve, logistic regression, and the Hosmer-Lemeshow goodness-of-fit test were used for statistical analyses [95% confidence interval (CI)]. Results: Data analysis showed a significant difference in PRISM III, PIM3, and PELOD-2 scores between survivors and nonsurvivors (P < 0.001, P < 0.001, P < 0.001, respectively). The discrimination power was moderate for PRISM III (area under ROC curve (AUC): 77.3%; standard error (SE): 6.0%), and good for PIM3 and PELOD-2 (AUC: 82.4%, SE: 5.5% and AUC: 80.3%, SE: 4.9%, respectively). All the three models were well calibrated (χ 2 = 4.73, P = 0.79; χ 2 = 3.09, P = 0.93; and χ 2 = 5.01, P = 0.66, respectively).Conclusions: PRISM III, PIM3, and PELOD-2 had good performance in predicting outcomes in children admitted to MICUs or SICUs. Further studies on different ICUs may provide more conclusive results with greater generalization of the validity of these predictive models.

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Comparison of acute physiology and chronic health evaluation II and Glasgow Coma Score in predicting the outcomes of Post Anesthesia Care Unit′s patients

Cited by 13 publications

References 27 publications

The ability of GCS, FOUR, and APACHE II in predicting the outcome of patients with traumatic brain injury: A comparative study

The ability of GCS, FOUR, and APACHE II in predicting the outcome of patients with traumatic brain injury: A comparative study

Acute Physiology and Chronic Health Evaluation II score for the assessment of mortality prediction in the intensive care unit: a single‐centre study from Iran

Comparison of the Predictive Ability of the Pediatric Risk of Mortality III, Pediatric Index of Mortality, and Pediatric Logistic Organ Dysfunction in Medical and Surgical Intensive Care Units

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