Validación de las escalas de APACHE II y SOFA en 2 cohortes de pacientes con sospecha de infección y sepsis, no ingresados en unidades de cuidados críticos

Cerro, L. Jiménez del; Valencia, Jenny García; Calle, Pilar Fernández; León, Alba; Jaimes, Fabián

doi:10.1016/j.redar.2013.11.014

Cited by 15 publications

(9 citation statements)

References 37 publications

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“…Severity and organ dysfunction scoring systems, such as APACHE II and SOFA, have been widely used and validated in various settings and populations 21 . Many of the physiological changes inherent to ED are considered in these indexes and can guide the maintenance performed by the health professional, in addition to that, SOFA allows the individual evaluation of each organ.…”

Section: Discussionmentioning

confidence: 99%

Prototype of a computerized scale for the active search for potential organ donors

Ludwig

Pereira

Martinez

et al. 2017

Rev. Latino-Am. Enfermagem

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Objective:to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. Method:methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. Results:34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. Conclusion:the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death.

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Section: Discussionmentioning

confidence: 99%

Prototype of a computerized scale for the active search for potential organ donors

Ludwig

Pereira

Martinez

et al. 2017

Rev. Latino-Am. Enfermagem

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“…Similar to our results, in Kim and Kim study,[ 30 ] there was a statistically significant difference between GCS and length of ICU stay in two groups of patients. The results of study conducted by Khwannimit and Geater,[ 16 ] were unlike ours, their study implemented in Thailand and APACHE II had excellent discrimination (AUC: 0.91, P < 0.001), but poor calibration (Hosmer-Lemeshow statistic was 66.59, P < 0.001), moreover, completing the study, Cerro et al .,[ 17 ] cited that APACHE II had no consistent performance for calibration and discrimination so concluded its application in emergency and in-hospital patients is limited. Perhaps these discrepancies can be explained by the fact that a scoring system based on a testing and validation set from one population when transferred to another population without modification will often lose predictive accuracy.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the previous studies have shown the good discriminative power, but different calibration for APACHE II and GCS. [ 8 11 13 14 15 16 17 18 ] Differences in the performance of these two scoring systems reinforce that the external validation is essential before routine usage, due to variation in case mix, structure and organization of acute medical care and lifestyles between populations. It is recommended by the researchers that regular re-calibration should be undertaken irrespective of what scoring system is selected, in order to minimize “model fade” and provide clinicians and managers interested in benchmarking a well-validated model to predict mortality.…”

Section: Introductionmentioning

confidence: 99%

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

Ramazani

2015

Saudi J Anaesth

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Context:Acute physiology and chronic health evaluation II (APACHE II) is one of the most general classification systems of disease severity in Intensive Care Units and Glasgow Coma Score (GCS) is one of the most specific ones.Aims:The aim of the current study was to assess APACHE II and GCS ability in predicting the outcomes (survivors, non-survivors) in the Post Anesthesia Care Unit's (PACU).Settings and Design:This was an observational and prospective study of 150 consecutive patients admitted in the PACU during 6-month period.Materials and Methods:Demographic information recorded on a checklist, also information about severity of disease calculated based on APACHE II scoring system in the first admission 24 h and GCS scale.Statistical Analysis Used:Logistic regression, Hosmer-Lemeshow test and receiver operator characteristic (ROC) curves were used in statistical analysis (95% confidence interval).Results:Data analysis showed a significant statistical difference between outcomes and both APACHE II and Glasgow Coma Score (GCS) (P < 0.0001). The ROC-curve analysis suggested that the predictive ability of GCS is slightly better than APACHE II in this study. For GCS the area under the ROC curve was 86.1% (standard error [SE]: 3.8%), and for APACHE II it was 85.7% (SE: 3.5%), also the Hosmer-Lemeshow statistic revealed better calibration for GCS (χ2 = 5.177, P = 0.521), than APACHE II (χ2 = 10.203, P = 0.251).Conclusions:The survivors had significantly lower APACHE II and higher GCS compared with non-survivors, also GCS showed more predictive accuracy than APACHE II in prognosticating the outcomes in PACU.

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“…Para categorizar la gravedad de la sepsis y la disfunción orgánica que ocasiona, se desarrollan las escalas de puntuación SOFA y APACHE II, utilizadas de manera amplia en diversos escenarios y/o poblaciones (130), con el objetivo de clasificar a los pacientes según el grado de compromiso que presentan, y predecir el riesgo de muerte valorando diversas variables (clínicas y analíticas) e indicando el grado de disfunción de órganos. Aunque ambas escalas no se originaron con la finalidad de ser exclusivamente utilizadas en el ámbito séptico, son universalmente utilizadas ante la sospecha de infección (130), (131), siendo potencialmente útiles para la toma de decisiones, para realizar procedimientos invasivos o la necesidad de ingreso en UCI así como para valorar la respuesta terapeútica (130). Sin embargo, recientemente se ha demostrado que estas escalas, fuera de los Servicios de UCI, carecen de eficacia para valorar al paciente séptico con exactitud (130), (132 Respiratorio⇨ pO2/FiO2: presión parcial de O2 y fracción inspiratoria de O2 (mmHg).…”

Section: Disfunción Multiorganicaunclassified

“…Aunque ambas escalas no se originaron con la finalidad de ser exclusivamente utilizadas en el ámbito séptico, son universalmente utilizadas ante la sospecha de infección (130), (131), siendo potencialmente útiles para la toma de decisiones, para realizar procedimientos invasivos o la necesidad de ingreso en UCI así como para valorar la respuesta terapeútica (130). Sin embargo, recientemente se ha demostrado que estas escalas, fuera de los Servicios de UCI, carecen de eficacia para valorar al paciente séptico con exactitud (130), (132 Respiratorio⇨ pO2/FiO2: presión parcial de O2 y fracción inspiratoria de O2 (mmHg). SR: soporte respiratorio (Puntos 3 y 4).…”

Section: Disfunción Multiorganicaunclassified

Características clínico-epidemiológicas de la uropatía obstructiva en un hospital terciario: factores de riesgo asociados a la sepsis grave

Núñez¹

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PPTa …………………………..……………..… Tiempo de tromboplastina parcial activado qSOFA …………………………...……………………………………………….. Quick SOFA QT …..………………..……………………………..……….…………………... Quimioterapia RLB UV……….……………….……………….…… Regresión logística binaria univariante RLB MV……….……………….……………….…… Regresión logística binaria univariante RM ….…..………………..…………………..……………… Resonancia magnética nuclear RPM….……………………………………..…………………….……. Residuo postmiccional Rpm ……………………………..…………………………………. Respiraciones por minuto RT ………..………………………..…….……...………….……………………... Radioterapia RTU ………………………………………………………… Resección transuretral de vejiga RVU ….…………..……………..……..………………….……………. Reflujo vesicoureteral SCCM …………………………………………………........Society of Critical Care Medicine Sepsis-1 ……..….…...…. Conceptos de sepsis de la primera conferencia de consenso Sepsis-2 …..…….….…. Conceptos de sepsis de la segunda conferencia de consenso Sepsis-3 ……………...…. Conceptos de sepsis de la tercera conferencia de consenso

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Validación de las escalas de APACHE II y SOFA en 2 cohortes de pacientes con sospecha de infección y sepsis, no ingresados en unidades de cuidados críticos

Cited by 15 publications

References 37 publications

Prototype of a computerized scale for the active search for potential organ donors

Prototype of a computerized scale for the active search for potential organ donors

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

Características clínico-epidemiológicas de la uropatía obstructiva en un hospital terciario: factores de riesgo asociados a la sepsis grave

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