Comparison of Acute Physiology and Chronic Health Evaluation (APACHE II) and Simplified Acute Physiology Score (SAPS II) in a Greek general intensive care unit

Objectives

To determine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system, as well as that of the Simplified Acute Physiology Score (SAPS II) in an interdisciplinary intensive care unit in Greece and to evaluate the scores' ability to predict hospital mortality.

Design

A prospective cohort study.

Setting

A mixed medical and surgical intensive care unit at a major general hospital in the Athens Metropolitan area, Greece.

Patients

A total of 309 adult patients, admitted to the ICU from January 2001 to January 2002, were enrolled in the study.

Methods and results

Data enabling the calculation of APACHE II and SAPS II were collected for every patient on the day of admission. Patients' vital status at hospital's discharge was recorded. Probabilities of hospital death for patients were estimated by applying APACHE II and SAPS II, and predicted risks of hospital death were compared with observed outcomes. The patients' median age was 57 years old. The median APACHE II score was 15, higher in the 105 female patients (16) than in the 204 male patients (15). The median APACHE II estimated probability of death was 0.16 (0.2 for female patients and 0.14 for male patients). The median APACHE II was lower in the 168 operative cases (14) than in the 141 medical ones (16). The median APACHE II estimated probability of death was respectively 0.13 and 0.20 for the two groups. The median SAPS II score was 37 (40 for females and 36 for males, 35 for operative patients and 41 for medical patients). The median SAPS II estimated probability of death was 0.2 (0.25 for females and 0.18 for males, 0.17 for operative cases and 0.27 for medical cases). The overall goodness of fit and the areas under the receiver operating characteristic curve were assessed for the two scores.