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The predictive value of serial acute physiology score (APS) and simplified acute physiology score II (SAPS II) in post-operative liver transplant patients

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Critical Care20004 (Suppl 1) :P240

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  • Emergency Medicine
  • Hospital Discharge
  • Full Text
  • Progressive Decrease
  • Prediction System

Full text


To evaluate the predictive value of daily acute physiology score (APS) of the APACHE II system and simplified acute physiology score II (SAPS II) in postoperative liver transplant patients.


Records of 20 consecutive postoperative liver transplant patients were reviewed. Daily APS and SAPS II scores were calculated for the first three days. Outcome at hospital discharge was documented. Values were compared using paired t-test and Kruskal-Wallis test.


APS and SAPS II were not significantly different between survivors and nonsurvivors on day 1 and 2 but were different on day 3 (see Table). APS and SAPS II decreased from day 1 to 2 in both survivors and nonsurvivors (-29% vs -31%, P=NS for APS, -24% vs-21%, P=NS for SAPS II). However, while APS and SAPS II continued to decrease from day 2 to 3 in survivors it increased in nonsurvivors (-15% vs +8%, P=0.03 for APS, -7% vs +5%, P=0.26).


In the postoperative liver transplant patients, the following are concluded: 1) in contrast to the progressive decrease in APS and SAPS II in survivors, these scores increased in nonsurvivors between day 2 and 3 after an initial drop; 2) day 3 APS and SAPS II scores better differentiated survivors from nonsurvivors than day 1 and 2 scores; 3) a mortality prediction system based on day 3 score or on serial scores is likely to be more accurate than the traditional systems using the first 24 h data.




Day 1

Day 2

Day 3

Day 1

Day 2

Day 3

Survivors (n=16)

16± 4

  11± 3a

 9± 4a

47± 11

   37± 13a

 32± 12a

Nonsurvivors (n=4)

 21± 7

13± 2

15± 3b

60± 9b

46± 9

49± 7b

a: P<0.05 compared to previous day, b: P<0.05 for survivors compared to nonsurvivors.

Authors’ Affiliations

Departments of Intensive Care and Hepatobiliary Sciences, King Fahad National Gurd Hospital, MC 1425, PO Box 22490, Riyadh, 11426, Saudi Arabia


© Current Science Ltd 2000