Mortality prediction models in intensive care

Castella, Xavier; Gilabert, Jaume; Torner, Francesc; Torres, Carles Santacana i

doi:10.1097/00003246-199102000-00014

Cited by 49 publications

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“…In contrast to other scores, such as the Ranson or the Glasgow system, the APACHE system allows The relation was significant: p Ͻ 0.0001. assessment beyond 48 hours after admission [17]. Studies have shown that the APACHE II score represents a reliable predictor of hospital outcome [18], and that it can be used prospectively as well as retrospectively [19,20]. Corresponding to the surgical literature dealing with the prediction of mortality by APACHE II scores, the expected mortality rates referring to a mean APACHE II score of 16 range from 35% to 50% [21][22][23].…”

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confidence: 99%

Surgical Treatment for Severe Acute Pancreatitis: Extent and Surgical Control of Necrosis Determine Outcome

et al. 2002

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In patients operated on for severe acute pancreatitis (SAP), the factors determining outcome remain unclear. From 1986 to 1998 a total of 340 patients with a diagnosis of SAP and in need of operative treatment were admitted to the intensive care unit (ICU) of a university hospital and a secondary care hospital. The mean APACHE II score on the day of admission was 16.1 (range 8-35). All patients required operative therapy. Among the 340 patients, 270 (79.4%) had to be reoperated: 196 patients (72.6%) underwent operative revisions on demand, and 74 (27.4%) patients had preplanned reoperation. The overall mortality was 39.1% (133 patients). Septic organ failure in 126 patients (37.1%) and myocardial infarction or pulmonary embolism in 7 patients (2%) were the causes of death. The patient's age (p < 0.0002), APACHE II scores at admission (p < 0.0001), presence or development of (single or multiple) organ failure (p < 0.002), infection (p < 0.02) and extent (p < 0.04) of pancreatic necrosis, and surgical control of local necrosis (p < 0.0001) significantly determined survival. SAP that requires surgical treatment is associated with high in-hospital mortality. Surgical control of local necrosis is the precondition for survival. Advanced age of the patient, high APACHE II score at admission, development of organ failure, and the extent and infection of pancreatic necrosis influence the outcome.

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