Sofa or Apache Ii, Which Deserves More Attention in Sepsis Patients in Icu? An Experience From a Tertiary Care Hospital in North East India

Abstract

BACKGROUND There are several well recognised scoring systems for evaluation and prognostication of critically ill patients. While APACHE II (Acute Physiology and Chronic Health Evaluation II) scoring system uses a point score based on physiologic parameters, age and previous health status, the SOFA (Sequential Organ Failure Assessment) scoring system takes into account the organ failure in critically ill patients. In the assessment of critically ill patients with suspected multiorgan dysfunction admitted in ICU, the role of SOFA in predictive validity for in-hospital mortality is being widely discussed. MATERIALS AND METHODS This was a prospective study undertaken in emergency ICU of a government tertiary care hospital in North East India over a period of one year to prognosticate the patients by using two different established scoring systems, e.g. SOFA and APACHE II. RESULTS The results showed that serial measurement of SOFA score during first week is a very useful tool in predicting the outcome especially on the day 3. The APACHE II score on day of admission, though reliable, was not very effective in predicting the mortality rate in our setup. CONCLUSION Serial measurement of SOFA score during first week is very useful tool in predicting the outcome of sepsis patients in ICU and better than admission APACHE II scoring in predicting mortality.

A Risk Prediction Model for Invasive Fungal Disease in Critically Ill Patients in the Intensive Care Unit

“…The possible reasons are as follows: (1) the physiological variables of APACHE II score are all dynamic and can be influenced by multiple factors, including fluid or blood infusion, making it a severity scale neither sensitive nor specific for ICU patients; (2) the scores for severity of illness in ICU patients vary depending on different regions and subgroups [13]. The SOFA score had better prediction effect than admission APACHE II score in predicting mortality of sepsis in India [14,15]. Similarly, patients with sepsis take up high proportion in our study (20.9%), which more or less leads to the results that APACHE II fails to distinguish IFD in those Chinese populations.…”