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The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study.
Medicine (Baltimore). 2019 06; 98(26):e16204.M

Abstract

Several prognostic indices have been employed to predict the outcome of surgical critically ill patients. Among them, acute physiology and chronic health evaluation (APACHE) II, sequential organ failure assessment (SOFA) and simplified acute physiology score (SAPS 3) are widely used. It seems that biological markers such as C-reactive protein (CRP), albumin, and blood lactate levels correlate with the degree of inflammation during the immediate postoperative phase and could be used as independent predictors. The objective of this study is to compare the different predictive values of prognostic indices and biological markers in the outcome of 847 surgical patients admitted to the intensive care unit (ICU) in the postoperative phase.The patients were divided into survivors (n = 765, 57.4% males, age 61, interquartile range 51-71) and nonsurvivors (n = 82, 57.3% males, age 70, interquartile range 58-79). APACHE II, APACHE II death probability (DP), SOFA, SAPS 3, SAPS 3 DP, CRP, albumin, and lactate were recorded on ICU admission (first 24 hours). The area under the ROC curve (AUROC) and 95% confidence interval (95% CI) were used to measure the index accuracy to predict mortality.The AUROC and 95% CI for APACHE II, APACHE II DP, SOFA, SAPS 3, SAPS 3 DP, CRP/albumin ratio, CRP, albumin, and lactate were 0.850 (0.824-0.873), 0.855 (0.829-0.878), 0.791 (0.762-0.818), 0.840 (0.813-0.864), 0.840 (0.813-0.864), 0.731 (0.700-0.761), 0.708 (0.676-0.739), 0.697 (0.665-0.728), and 0.601 (0.567-0.634), respectively. The ICU and overall in-hospital mortality were 6.6 and 9.7%, respectively. The APACHE II, APACHE II DP, SAPS 3, SAPS 3 DP, and SOFA scores showed a better performance than CRP/albumin ratio, CRP, albumin, or lactate to predict in-hospital mortality of surgical critically ill patients.Even though all indices were able to discriminate septic from nonseptic patients, only APACHE II, APACHE II DP, SOFA and to a lesser extent SAPS 3, SAPS 3 DP, and blood lactate levels could predict in the first 24-hour ICU admission surgical patients who have survived sepsis.

Authors+Show Affiliations

Division of Intensive Care Medicine, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo.Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.Intensive Care Unit, Hospital das Clínicas de Ribeirão Preto.Intensive Care Unit, Hospital São Francisco, Ribeirão Preto, SP, Brasil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31261567

Citation

Basile-Filho, Anibal, et al. "The Use of APACHE II, SOFA, SAPS 3, C-reactive Protein/albumin Ratio, and Lactate to Predict Mortality of Surgical Critically Ill Patients: a Retrospective Cohort Study." Medicine, vol. 98, no. 26, 2019, pp. e16204.
Basile-Filho A, Lago AF, Menegueti MG, et al. The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study. Medicine (Baltimore). 2019;98(26):e16204.
Basile-Filho, A., Lago, A. F., Menegueti, M. G., Nicolini, E. A., Rodrigues, L. A. B., Nunes, R. S., Auxiliadora-Martins, M., & Ferez, M. A. (2019). The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study. Medicine, 98(26), e16204. https://doi.org/10.1097/MD.0000000000016204
Basile-Filho A, et al. The Use of APACHE II, SOFA, SAPS 3, C-reactive Protein/albumin Ratio, and Lactate to Predict Mortality of Surgical Critically Ill Patients: a Retrospective Cohort Study. Medicine (Baltimore). 2019;98(26):e16204. PubMed PMID: 31261567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of APACHE II, SOFA, SAPS 3, C-reactive protein/albumin ratio, and lactate to predict mortality of surgical critically ill patients: A retrospective cohort study. AU - Basile-Filho,Anibal, AU - Lago,Alessandra Fabiane, AU - Menegueti,Mayra Gonçalves, AU - Nicolini,Edson Antonio, AU - Rodrigues,Lorena Aparecida de Brito, AU - Nunes,Roosevelt Santos, AU - Auxiliadora-Martins,Maria, AU - Ferez,Marcus Antonio, PY - 2019/7/3/entrez PY - 2019/7/3/pubmed PY - 2019/7/23/medline SP - e16204 EP - e16204 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 26 N2 - Several prognostic indices have been employed to predict the outcome of surgical critically ill patients. Among them, acute physiology and chronic health evaluation (APACHE) II, sequential organ failure assessment (SOFA) and simplified acute physiology score (SAPS 3) are widely used. It seems that biological markers such as C-reactive protein (CRP), albumin, and blood lactate levels correlate with the degree of inflammation during the immediate postoperative phase and could be used as independent predictors. The objective of this study is to compare the different predictive values of prognostic indices and biological markers in the outcome of 847 surgical patients admitted to the intensive care unit (ICU) in the postoperative phase.The patients were divided into survivors (n = 765, 57.4% males, age 61, interquartile range 51-71) and nonsurvivors (n = 82, 57.3% males, age 70, interquartile range 58-79). APACHE II, APACHE II death probability (DP), SOFA, SAPS 3, SAPS 3 DP, CRP, albumin, and lactate were recorded on ICU admission (first 24 hours). The area under the ROC curve (AUROC) and 95% confidence interval (95% CI) were used to measure the index accuracy to predict mortality.The AUROC and 95% CI for APACHE II, APACHE II DP, SOFA, SAPS 3, SAPS 3 DP, CRP/albumin ratio, CRP, albumin, and lactate were 0.850 (0.824-0.873), 0.855 (0.829-0.878), 0.791 (0.762-0.818), 0.840 (0.813-0.864), 0.840 (0.813-0.864), 0.731 (0.700-0.761), 0.708 (0.676-0.739), 0.697 (0.665-0.728), and 0.601 (0.567-0.634), respectively. The ICU and overall in-hospital mortality were 6.6 and 9.7%, respectively. The APACHE II, APACHE II DP, SAPS 3, SAPS 3 DP, and SOFA scores showed a better performance than CRP/albumin ratio, CRP, albumin, or lactate to predict in-hospital mortality of surgical critically ill patients.Even though all indices were able to discriminate septic from nonseptic patients, only APACHE II, APACHE II DP, SOFA and to a lesser extent SAPS 3, SAPS 3 DP, and blood lactate levels could predict in the first 24-hour ICU admission surgical patients who have survived sepsis. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31261567/The_use_of_APACHE_II_SOFA_SAPS_3_C_reactive_protein/albumin_ratio_and_lactate_to_predict_mortality_of_surgical_critically_ill_patients:_A_retrospective_cohort_study_ L2 - https://doi.org/10.1097/MD.0000000000016204 DB - PRIME DP - Unbound Medicine ER -