The APACHE II Score as a Predictor of Mortality After Open Heart Surgery

Yalçın, Mihriban; Gödekmerdan, Eda; Tayfur, Kaptanıderya; Yazman, Serkan; Ürkmez, Melih; Ata, Yusuf

doi:10.5152/tjar.2018.44365

Cited by 9 publications

(8 citation statements)

References 27 publications

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“…First, the APACHE II score is currently the most authoritative critical illness evaluation and can reflect the severity of pathophysiological changes in patients. 20) EuroSCORE is the most well-known system assessing the risk factors before cardiovascular surgery. 21) However, it does not include intraoperative risk factors, such as those for CPB.…”

Section: Discussionmentioning

confidence: 99%

A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass

Zhong

Zhang

Peng

et al. 2024

ATCS

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Purpose: Intensive care unit-acquired weakness (ICUAW) affects patient prognosis after cardiopulmonary bypass (CPB) surgery, but its risk factors remain unclear. We investigated these risk factors and developed a nomogram for predicting ICUAW after CPB. Methods: Baseline characteristics, preoperative laboratory data, and intra-and postoperative variables of 473 patients after CPB were determined in this prospective cohort study. Lower limb muscles on bedside ultrasound images were compared 1 day before and 7 days after CPB. Risk factors were assessed using logistic regression models. Results: Approximately 50.95% of the patients developed ICUAW after CPB. The body mass index (BMI), New York Heart Association (NYHA) class, lactate, albumin, aortic clamping time, operation time, and acute physiological and chronic health evaluation II were determined as independent risk factors. The average absolute error of coincidence was 0.019; the area under the curve, sensitivity, and specificity were 0.811, 0.727, and 0.733, respectively, for the predictive nomogram. Conclusion: A high BMI, poor NYHA class, preoperative high serum lactate, low serum albumin, long surgical duration, aortic clamping, and high acute physiological and chronic health evaluation II score are risk factors for ICUAW after CPB. This robust and easy-to-use nomogram was developed for clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass

Zhong

Zhang

Peng

et al. 2024

ATCS

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“…Accurate prognostic indicators of survival in ICU patients are important and helpful in guiding clinical decisionmaking (15). Currently, severity scores (such as Acute Physiology and Chronic Health Evaluation (APACHE) and Sepsis-related Organ Failure Assessment(SOFA) scores), along with clinical and laboratory variables, are commonly used to track the function of multiple organ systems (16)(17)(18)(19). Cytokines have been indicated to play important roles in host defense and the maintenance of tissue homeostasis; however, abnormal cytokine production can damage these functions, resulting in inflammation and tissue injury (20).…”

Section: Discussionmentioning

confidence: 99%

The predictive prognostic values of serum interleukin-2, interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin in surgical intensive care unit patients

Yan¹,

Hu²,

Wang³

et al. 2021

Ann Transl Med

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Background: The pathophysiological roles of serum cytokine levels in critically ill surgical patients has yet to be determined. This study aimed to determine the predictive prognostic values of serum interleukin IL-2, IL-6, IL-8, tumor necrosis factor-α (TNF-α), and procalcitonin (PCT) in surgical intensive care unit (ICU) patients.Methods: Cytokine concentrations were measured with an IMMULITE 1000 Immunoassay System

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“…Consequently, there is an urgent demand for better identification of variables for high-risk patients. At present, the determination of ICU patient risk mainly relies on clinical judgment and severity scores (such as APACHE scores), which incorporate patients' previous health statuses, along with clinical and laboratory variables, which track the function of multiple organ systems [13][14][15][16]. In recent decades, our knowledge of the biochemical processes underlying critical illness has considerably improved.…”

Section: Discussionmentioning

confidence: 99%

The associations between cytokine levels and clinical outcomes in critically ill patients after surgery: a retrospective cohort study

Yan¹,

Wang²,

Hu³

et al. 2020

Preprint

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Background The associations of serum cytokine levels and critically ill patient outcomes after surgery remain unclear. The use of cytokine markers to predict outcomes in critically ill patients is controversial. Objective To determine the levels of IL-1β, IL-2, IL-6, IL-8, IL-10, TNF-α and procalcitonin in critical surgical ICU (SICU) patients and evaluate their associations with patient outcome and clinical significance. Methods This was a retrospective cohort study of consecutive patients admitted to the SICU in Zhongshan Hospital, Fudan University. The program ran from January 1, 2018, to June 30, 2019. The levels of IL-1β, IL-2, IL-6, IL-8, IL-10, TNF-α and procalcitonin were detected, and their relationship with patient outcomes was investigated. The primary outcome was in-hospital mortality, compared by a multivariable logistic regression analysis among the survivors and nonsurvivors. Results Overall, 5,257 patients were included in this study for their first SICU admission; 5,099 patients survived, 158 patients died, and the mortality rate was 3.0% (158/5,257). Univariate and multivariate analyses showed that nonsurvivors had increased levels of IL-1β (OR = 1.855, P = 0.000) and IL-2 (OR = 1.51, P = 0.000) compared with survivors. In addition, 196 patients (3.7%) were readmitted to the SICU, and data from 187 patients were collected. Of these, 161 patients survived, and 26 patients died; the mortality rate was 13.9% (26/187), which was much higher than that of the first round of patients. The level of IL-2 significantly influenced SICU readmission (OR = 3.921, P = 0.000). For the third round of SICU admission, 10 patients were included, 7 patients survived, and 3 patients died; the mortality rate was 30.0% (3/10). Furthermore, older age, longer time of SICU stay, and higher rate of mechanical ventilation and CRRT were associated with patient death. Conclusions High levels of cytokines may be risk factors for mortality and SICU readmission in critically ill patients who receive surgery. Further work is still needed to determine which unmeasured characteristics and therapies may contribute to the increased risk observed.

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The APACHE II Score as a Predictor of Mortality After Open Heart Surgery

Abstract: the manuscript, references should be cited using Arabic numbers in parentheses. The reference styles for different types of publications are presented in the following examples.

Cited by 9 publications

References 27 publications

A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass

A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass

The predictive prognostic values of serum interleukin-2, interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin in surgical intensive care unit patients

The associations between cytokine levels and clinical outcomes in critically ill patients after surgery: a retrospective cohort study

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