Predicting scores correlations in patients with septic shock - a cohort study.

BACKGROUND: ICU prognostic scores were developed to measure the severity of the disease and the patients' prognosis. The objective of this study was to assess the validity of the Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score II (SAPS II) scores in patients with septic shock. METHODS: The APACHE II, SOFA and SAPS II scores were determined prospectively, in the first 24 hours after admission, for all 56 patients with septic shock who were included in this study. Data were statistically evaluated; the discriminating power regarding survivors vs deceased patients was calculated based on the receiver operating characteristic curves (ROC). RESULTS: The overall mortality of the 56 patients with septic shock was 60.71% (34 deaths). The average APACHE II score was 25.36 ± 7.477. The average SOFA score was 7.679 ± 3.197. The average SAPS II score was 44.45 ± 16.97. For the APACHE II and SOFA scores the differences when deceased and survivors were compared were not statistically significant (APACHE II: 26.76 ± 6.742 vs 23.18 ± 8.175 respectively for SOFA: 8.029 ± 3.099 vs 7.136 ± 3.342). For the SAPS II score the values are: 49.12 ± 16.61 in deceased vs 37.23 ± 15.20 in survivors, the difference being statistically significant (p = 0.0092). The areas under ROC for the three scores are 0.622 for APACHE II, 0.575 for SAPS II and 0.705 for SOFA. CONCLUSIONS: In our study the SAPS II score was superior to the other scores for predicting survival in patients with septic shock.