A Prospective Study of Comparison of APACHE- I V & SAPS- I I Scoring Systems and Calculation of Standardised Mortality Rate in Severe Sepsis and Septic Shock Patients
Ajay Somabhai Dabhi
Abstract
Ajay Somabhai Dabhi
Abstract
CONTEXT: Severe sepsis and septic shock are major causes of mortality in the Intensive Care Unit (ICU) Illness Scoring Systems can help in the prediction of outcome of these patients. AIM: To calculate and compare APACHE-IV and SAPS-II Scoring Systems along with calculation of Standardised Mortality Rate (SMR) in patients of severe sepsis and septic shock in the ICU. STUDY DESIGN: Observational-analytical prospective study. MATERIALS AND METHODS: The study was conducted on 84 patients with severe sepsis and septic shock admitted to the Medical ICU of a tertiary care teaching hospital. RESULTS: Mean of Predicted Mortality Rate (PMR) for APACHE-IV was 37.85% and for SAPS-II, it was 72.36% which shows that APACHE-IV had under-predicted overall mortality while SAPS-II had over-predicted overall mortality of patients with severe sepsis and septic shock. Standardised Mortality Rate for APACHE-IV was 1.60 and for SAPS-II, it was 0.83. CONCLUSION: Predicted Mortality of APACHE-IV and SAPS-II Scoring Systems did not correlate with the observed mortality for patients with severe sepsis and septic shock.
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CONTEXT: Severe sepsis and septic shock are major causes of mortality in the Intensive Care Unit (ICU) Illness Scoring Systems can help in the prediction of outcome of these patients. AIM: To calculate and compare APACHE-IV and SAPS-II Scoring Systems along with calculation of Standardised Mortality Rate (SMR) in patients of severe sepsis and septic shock in the ICU. STUDY DESIGN: Observational-analytical prospective study. MATERIALS AND METHODS: The study was conducted on 84 patients with severe sepsis and septic shock admitted to the Medical ICU of a tertiary care teaching hospital. RESULTS: Mean of Predicted Mortality Rate (PMR) for APACHE-IV was 37.85% and for SAPS-II, it was 72.36% which shows that APACHE-IV had under-predicted overall mortality while SAPS-II had over-predicted overall mortality of patients with severe sepsis and septic shock. Standardised Mortality Rate for APACHE-IV was 1.60 and for SAPS-II, it was 0.83. CONCLUSION: Predicted Mortality of APACHE-IV and SAPS-II Scoring Systems did not correlate with the observed mortality for patients with severe sepsis and septic shock.
Key concepts: Septic shock, APACHE II, SAPS II, Medicine, Sepsis, Mortality rate, Shock (circulatory), Intensive care unit