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Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong.
Resuscitation. 2007 Aug; 74(2):259-65.R

Abstract

INTRODUCTION

Numerous prognostic predictive models have been developed for critically ill patients, many of which are primarily designed for use in intensive care units. The objective of this study was to evaluate the accuracy of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in predicting the mortality for critically ill patients managed in emergency department (ED) resuscitation rooms in Hong Kong.

METHOD

A multi-centre, prospective study was conducted for patients managed in the resuscitation rooms of the EDs of four major hospitals, including one university teaching hospital. The primary outcome measure was 14 day all-cause mortality and the secondary outcome measure was the length of stay in hospital.

RESULTS

Of 867 patients recruited between 4 and 30 April 2004, 106 (12.2%) patients died. The modified APACHE II score was found to be significantly higher in non-survivors compared to survivors (mean+/-S.D.: 21.2+/-7.7 versus 14.4+/-7.1, p<0.001). The area under the curve for modified APACHE II in predicting mortality was 0.743 (95% CI, 0.696-0.790).

CONCLUSION

The modified APACHE II score is only a moderate predictor of mortality for critically ill patients managed in the resuscitation rooms of EDs in Hong Kong. A more ED specific scoring method is required.

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Authors+Show Affiliations

Man SY
Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Hong Kong SAR, China.
Chan KM
No affiliation info available
Wong FY
No affiliation info available
Wong KY
No affiliation info available
Yim CL
No affiliation info available
Mak PS
No affiliation info available
Kam CW
No affiliation info available
Lau CC
No affiliation info available
Lau FL
No affiliation info available
Graham CA
No affiliation info available
Rainer TH
No affiliation info available

MeSH

APACHEAdultAgedAged, 80 and overAnalysis of VarianceCritical IllnessEmergency Service, HospitalFemaleHong KongHospital MortalityHumansLogistic ModelsMaleMiddle AgedPredictive Value of TestsProspective StudiesROC CurveReproducibility of ResultsResuscitationSurvival Rate

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

17379379

Citation

Man, Shin Yan, et al. "Evaluation of the Performance of a Modified Acute Physiology and Chronic Health Evaluation (APACHE II) Scoring System for Critically Ill Patients in Emergency Departments in Hong Kong." Resuscitation, vol. 74, no. 2, 2007, pp. 259-65.
Man SY, Chan KM, Wong FY, et al. Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong. Resuscitation. 2007;74(2):259-65.
Man, S. Y., Chan, K. M., Wong, F. Y., Wong, K. Y., Yim, C. L., Mak, P. S., Kam, C. W., Lau, C. C., Lau, F. L., Graham, C. A., & Rainer, T. H. (2007). Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong. Resuscitation, 74(2), 259-65.
Man SY, et al. Evaluation of the Performance of a Modified Acute Physiology and Chronic Health Evaluation (APACHE II) Scoring System for Critically Ill Patients in Emergency Departments in Hong Kong. Resuscitation. 2007;74(2):259-65. PubMed PMID: 17379379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong. AU - Man,Shin Yan, AU - Chan,Ka Man, AU - Wong,Fung Yi, AU - Wong,Kit Yi, AU - Yim,Chi Lap, AU - Mak,Paulina S K, AU - Kam,Chak Wah, AU - Lau,Chor Chiu, AU - Lau,Fei Lung, AU - Graham,Colin A, AU - Rainer,Timothy H, Y1 - 2007/03/26/ PY - 2006/11/12/received PY - 2006/12/14/revised PY - 2006/12/18/accepted PY - 2007/3/24/pubmed PY - 2007/11/9/medline PY - 2007/3/24/entrez SP - 259 EP - 65 JF - Resuscitation JO - Resuscitation VL - 74 IS - 2 N2 - INTRODUCTION: Numerous prognostic predictive models have been developed for critically ill patients, many of which are primarily designed for use in intensive care units. The objective of this study was to evaluate the accuracy of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in predicting the mortality for critically ill patients managed in emergency department (ED) resuscitation rooms in Hong Kong. METHOD: A multi-centre, prospective study was conducted for patients managed in the resuscitation rooms of the EDs of four major hospitals, including one university teaching hospital. The primary outcome measure was 14 day all-cause mortality and the secondary outcome measure was the length of stay in hospital. RESULTS: Of 867 patients recruited between 4 and 30 April 2004, 106 (12.2%) patients died. The modified APACHE II score was found to be significantly higher in non-survivors compared to survivors (mean+/-S.D.: 21.2+/-7.7 versus 14.4+/-7.1, p<0.001). The area under the curve for modified APACHE II in predicting mortality was 0.743 (95% CI, 0.696-0.790). CONCLUSION: The modified APACHE II score is only a moderate predictor of mortality for critically ill patients managed in the resuscitation rooms of EDs in Hong Kong. A more ED specific scoring method is required. SN - 0300-9572 UR - https://www.unboundmedicine.com/medline/citation/17379379/Evaluation_of_the_performance_of_a_modified_Acute_Physiology_and_Chronic_Health_Evaluation__APACHE_II__scoring_system_for_critically_ill_patients_in_emergency_departments_in_Hong_Kong_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0300-9572(07)00009-3 DB - PRIME DP - Unbound Medicine ER -