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Title: Predicting scores correlations in patients with septic shock - a cohort study.
Author: Georgescu AM, Szederjesi J, Copotoiu SM, Azamfirei L.
Journal: Rom J Anaesth Intensive Care; 2014 Oct; 21(2):95-98. PubMed ID: 28913439.
Abstract:
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. PREMIZE: Scorurile de prognostic utilizate în Terapie Intensivă au fost dezvoltate cu scopul de a cuantifica severitatea boli şi prognosticul pacientului. Obiectivul acestui studiu a fost de a aprecia validitatea scorurile utilizate în prezent (APACHE II, SOFA şi SAPS II) în cazul pacienţilor cu şoc septic. METODĂ: Au fost calculate în primele 24 de ore de la internare, scorurile APACHE II, SOFA şi SAPS II pentru toţi cei 56 de pacienţi, cu şoc septic, care au fost înrolaţi prospectiv în studiu. Datele obţinute au fost evaluate statistic iar puterea de diferenţiere dintre supravieţuitori vs decedaţi a fost calculată conform curbelor ROC (receiver operating characteristic). REZULTATE: Mortalitatea generală a celor 56 de pacienţi cu şoc septic a fost de 60,71% (34 decese). Scorul mediu APACHE II a fost de 25,36 ± 7,477, scorul mediu SOFA a fost de 7,679 ± 3,197 iar scorul mediu SAPS II de 44,45 ± 16,97. Pentru scorurile APACHE II şi SOFA diferenţele dintre supravieţuitori şi decedaţi nu au fost semnificative statistic (APACHE II: 26,76 ± 6,742 vs 23,18 ± 8,175 respectiv pentru SOFA: 8,029 ± 3,099 vs 7,136 ± 3,342). Scorurile SAPS II medii au fost în cazul decedaţilor de 49,12 ± 16,61 vs 37, 23 ± 15,20 în cazul supravieţuitorilor, cu o diferenţă semnificativă statistic între grupuri (p = 0,0092). Ariile de sub curbele ROC pentru cele trei scoruri au fost 0,622 pentru APACHE II, 0,575 pentru SAPS II şi 0,705 pentru SOFA. CONCLUZII: În studiul nostru scorul SAPS II a fost superior celorlalte scoruri în ce priveşte capacitatea de predicţie a supravieţuirii la pacientul cu şoc septic.

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