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APACHE II and SOFA scores for intensive care and hospital outcome prediction in oncologic patients

Introduction

The number of acute organ failures has been shown to be an important determinant of prognosis in critically ill cancer patients admitted to an ICU [1]. Although the SOFA score is useful in analyzing the number and the severity of acute organ failures related to ICU mortality, it is not validated to predict outcomes in the ICU. On the other hand, general prognostic models have failed to accurately predict outcomes in the oncologic population [2, 3]. Given this, we propose to analyze the ability of the SOFA score compared with the APACHE II score in predicting ICU and inhospital mortality in oncologic patients.

Methods

ICU data from a tertiary university hospital were prospectively collected from March 2003 to November 2005. Oncologic patients with an ICU admission longer than 24 hours were selected. The SOFA and APACHE II scores were retrieved from our prospectively acquired database. The accuracy of the APACHE II, first-day SOFA (SOFA1) and maximum SOFA during the entire ICU admission (mSOFA) scores were analyzed through the area under the ROC curve (AUC).

Results

Seventy out of 793 patients had an oncologic diagnosis. Eleven patients were excluded due to an ICU length of stay less than 24 hours. One patient had missing SOFA data. Of the 58 analyzed patients, the mean age was 52 ± 18 years, male gender 53%, medical admission 74%, hematological malignancies 50% and mean APACHE II score 20 ± 8. The ICU mortality was 43% and the inhospital mortality was 65%. The accuracy of the scores for mortality prediction is presented in Table 1.

Table 1

Conclusion

The accuracy of the APACHE II score to predict ICU and inhospital mortality in critically ill cancer patients was modest and similar to the described in the literature. The severity of multiple organ failure evaluated through the SOFA score on day 1 and the maximum SOFA score reached a better accuracy to predict both ICU and hospital mortality in an oncologic population.

References

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Forte, D., Ranzani, O., Stape, N. et al. APACHE II and SOFA scores for intensive care and hospital outcome prediction in oncologic patients. Crit Care 11, P93 (2007). https://doi.org/10.1186/cc5880

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Keywords

  • Oncologic Patient
  • Sofa Score
  • Medical Admission
  • Mortality Prediction
  • Inhospital Mortality