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Prospective cohort study comparing sequential organ failure assessment and acute physiology, age, chronic health evaluation III scoring systems for hospital mortality prediction in critically ill cirrhotic patients.
Int J Clin Pract. 2006 Feb; 60(2):160-6.IJ

Abstract

The aim of the study was to evaluate the usefulness of sequential organ failure assessment (SOFA) and acute physiology, age, chronic health evaluation III (APACHE III) scoring systems obtained on the first day of intensive care unit (ICU) admission in predicting hospital mortality in critically ill cirrhotic patients. The study enrolled 102 cirrhotic patients consecutively admitted to ICU during a 1-year period. Twenty-five demographic, clinical and laboratory variables were analysed as predicators of survival. Information considered necessary to calculate the Child-Pugh, SOFA and APACHE III scores on the first day of ICU admission was also gathered. Overall hospital mortality was 68.6%. Multiple logistic regression analysis revealed that mean arterial pressure, SOFA and APACHE III scores were significantly related to prognosis. Goodness-of-fit was good for the SOFA and APACHE III models. Both predictive models displayed a similar degree of the best Youden index (0.68) and overall correctness (84%) of prediction. The SOFA and APACHE III models displayed good areas under the receiver-operating characteristic curve (0.917 +/- 0.028 and 0.912 +/- 0.029, respectively). Finally, a strong and significant positive correlation exists between SOFA and APACHE III scores for individual patients (r(2) = 0.628, p < 0.001). This investigation confirms the grave prognosis for cirrhotic patients admitted to ICU. Both SOFA and APACHE III scores are excellent tools to predict the hospital mortality in critically ill cirrhotic patients. The overall predictive accuracy of SOFA and APACHE III is superior to that of Child-Pugh system. The role of these scoring systems in describing the dynamic aspects of clinical courses and allocating ICU resources needs to be clarified.

Authors+Show Affiliations

Division of Critical Care Nephrology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16451287

Citation

Chen, Y-C, et al. "Prospective Cohort Study Comparing Sequential Organ Failure Assessment and Acute Physiology, Age, Chronic Health Evaluation III Scoring Systems for Hospital Mortality Prediction in Critically Ill Cirrhotic Patients." International Journal of Clinical Practice, vol. 60, no. 2, 2006, pp. 160-6.
Chen YC, Tian YC, Liu NJ, et al. Prospective cohort study comparing sequential organ failure assessment and acute physiology, age, chronic health evaluation III scoring systems for hospital mortality prediction in critically ill cirrhotic patients. Int J Clin Pract. 2006;60(2):160-6.
Chen, Y. C., Tian, Y. C., Liu, N. J., Ho, Y. P., Yang, C., Chu, Y. Y., Chen, P. C., Fang, J. T., Hsu, C. W., Yang, C. W., & Tsai, M. H. (2006). Prospective cohort study comparing sequential organ failure assessment and acute physiology, age, chronic health evaluation III scoring systems for hospital mortality prediction in critically ill cirrhotic patients. International Journal of Clinical Practice, 60(2), 160-6.
Chen YC, et al. Prospective Cohort Study Comparing Sequential Organ Failure Assessment and Acute Physiology, Age, Chronic Health Evaluation III Scoring Systems for Hospital Mortality Prediction in Critically Ill Cirrhotic Patients. Int J Clin Pract. 2006;60(2):160-6. PubMed PMID: 16451287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective cohort study comparing sequential organ failure assessment and acute physiology, age, chronic health evaluation III scoring systems for hospital mortality prediction in critically ill cirrhotic patients. AU - Chen,Y-C, AU - Tian,Y-C, AU - Liu,N-J, AU - Ho,Y-P, AU - Yang,C, AU - Chu,Y-Y, AU - Chen,P-C, AU - Fang,J-T, AU - Hsu,C-W, AU - Yang,C-W, AU - Tsai,M-H, PY - 2006/2/3/pubmed PY - 2006/8/5/medline PY - 2006/2/3/entrez SP - 160 EP - 6 JF - International journal of clinical practice JO - Int J Clin Pract VL - 60 IS - 2 N2 - The aim of the study was to evaluate the usefulness of sequential organ failure assessment (SOFA) and acute physiology, age, chronic health evaluation III (APACHE III) scoring systems obtained on the first day of intensive care unit (ICU) admission in predicting hospital mortality in critically ill cirrhotic patients. The study enrolled 102 cirrhotic patients consecutively admitted to ICU during a 1-year period. Twenty-five demographic, clinical and laboratory variables were analysed as predicators of survival. Information considered necessary to calculate the Child-Pugh, SOFA and APACHE III scores on the first day of ICU admission was also gathered. Overall hospital mortality was 68.6%. Multiple logistic regression analysis revealed that mean arterial pressure, SOFA and APACHE III scores were significantly related to prognosis. Goodness-of-fit was good for the SOFA and APACHE III models. Both predictive models displayed a similar degree of the best Youden index (0.68) and overall correctness (84%) of prediction. The SOFA and APACHE III models displayed good areas under the receiver-operating characteristic curve (0.917 +/- 0.028 and 0.912 +/- 0.029, respectively). Finally, a strong and significant positive correlation exists between SOFA and APACHE III scores for individual patients (r(2) = 0.628, p < 0.001). This investigation confirms the grave prognosis for cirrhotic patients admitted to ICU. Both SOFA and APACHE III scores are excellent tools to predict the hospital mortality in critically ill cirrhotic patients. The overall predictive accuracy of SOFA and APACHE III is superior to that of Child-Pugh system. The role of these scoring systems in describing the dynamic aspects of clinical courses and allocating ICU resources needs to be clarified. SN - 1368-5031 UR - https://www.unboundmedicine.com/medline/citation/16451287/Prospective_cohort_study_comparing_sequential_organ_failure_assessment_and_acute_physiology_age_chronic_health_evaluation_III_scoring_systems_for_hospital_mortality_prediction_in_critically_ill_cirrhotic_patients_ L2 - https://doi.org/10.1111/j.1742-1241.2005.00634.x DB - PRIME DP - Unbound Medicine ER -