2013PubMedRequires access

[Illness severity and prognosis assessment with acute physiology and chronic health evaluation II for patients after cardiovascular surgery].

Shuhong Wang, Guoping He, Cui Zeng, Jianhui Zhou, Xiaochen Xia

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Abstract

OBJECTIVE: To evaluate illness severity and to assess the prognosis with acute physiology and chronic health evaluation II (APACHE II) for patients after cardiovascular surgery. METHODS: APACHE II scores of 234 patients in the cardiac surgical intensive care unit (CSICU) were calculated, and the actual mortality and the predicted mortality were obtained based on the score. RESULTS: The APACHE II score of the 234 patients was 14.22±6.77. The difference in the APACHE II score between the survivors, the patients with complications and the death group was significant; the difference in the APACHE II score between patients with different preoperative cardiac functions was significant; the detention time in the CSICU was positively related to APACHE II scores; and the ROC area under the curve of APACHE II was 0.991±0.006. With the predicted rate >30% as the standard for death, sensitivity of APACHE II score for mortality risk prediction was 80.00%, specificity was 99.12%, and the accuracy was 98.72%. According to the score, we divided the patients into 3 groups (<10 points, 10-20 points, >20 points), forecast mortality in the >20 point group was in the 95% confidence interval of actual mortality. CONCLUSION: APACHE II is a good index for illness severity and prognosis assessment for patients after cardiovascular surgery.

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What this paper is about

OBJECTIVE: To evaluate illness severity and to assess the prognosis with acute physiology and chronic health evaluation II (APACHE II) for patients after cardiovascular surgery. METHODS: APACHE II scores of 234 patients in the cardiac surgical intensive care unit (CSICU) were calculated, and the actual mortality and the predicted mortality were obtained based on the score. RESULTS: The APACHE II score of the 234 patients was 14.22±6.77. The difference in the APACHE II score between the survivors, the patients with complications and the death group was significant; the difference in the APACHE II score between patients with different preoperative cardiac functions was significant; the detention time in the CSICU was positively related to APACHE II scores; and the ROC area under the curve of APACHE II was 0.991±0.006. With the predicted rate >30% as the standard for death, sensitivity of APACHE II score for mortality risk prediction was 80.00%, specificity was 99.12%, and the accuracy was 98.72%. According to the score, we divided the patients into 3 groups (<10 points, 10-20 points, >20 points), forecast mortality in the >20 point group was in the 95% confidence interval of actual mortality. CONCLUSION: APACHE II is a good index for illness severity and prognosis assessment for patients after cardiovascular surgery.

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Available abstract

OBJECTIVE: To evaluate illness severity and to assess the prognosis with acute physiology and chronic health evaluation II (APACHE II) for patients after cardiovascular surgery. METHODS: APACHE II scores of 234 patients in the cardiac surgical intensive care unit (CSICU) were calculated, and the actual mortality and the predicted mortality were obtained based on the score. RESULTS: The APACHE II score of the 234 patients was 14.22±6.77. The difference in the APACHE II score between the survivors, the patients with complications and the death group was significant; the difference in the APACHE II score between patients with different preoperative cardiac functions was significant; the detention time in the CSICU was positively related to APACHE II scores; and the ROC area under the curve of APACHE II was 0.991±0.006. With the predicted rate >30% as the standard for death, sensitivity of APACHE II score for mortality risk prediction was 80.00%, specificity was 99.12%, and the accuracy was 98.72%. According to the score, we divided the patients into 3 groups (<10 points, 10-20 points, >20 points), forecast mortality in the >20 point group was in the 95% confidence interval of actual mortality. CONCLUSION: APACHE II is a good index for illness severity and prognosis assessment for patients after cardiovascular surgery.

Key concepts: Medicine, APACHE II, Intensive care unit, Confidence interval, Internal medicine, Cardiac surgery, Mortality rate, Severity of illness

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