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Indian Journal of Emergency Medicine

Volume  5, Issue 4, October-December 2019, Pages 225-232
 

Original Article

Comparison of Acute Physiology and Chronic Health Assessment II (APACHE II) Score and Sequential Organ Failure Assessment (SOFA) Score as A Mortality Predictor in ED-ICU Patients

Hariprasad Kanakapura Veerendranath1, Ravikanti Karthik2, Murali Mohan NT3, Gaganam Trimurty4, Siddraj Wali5

1Assistant Professor, Department of Emergency Medicine, Ramaiah Medical College, Mathikere, Bengaluru, Karnataka 560054, India. 2Assistant Professor, 3Professor and Head, 4Professor, 5Assistant Professor, Department of Emergency Medicine, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bengaluru, Karnataka 560066, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.5419.2

Abstract

Background and Objectives: Currently the Acute physiology and chronic health Assessment II (APACHE II) scoring system is widely used. A controversy exists as to which is an ideal scoring system so we conducted a study to assess and compare the effectiveness of Apache II score and sequential organ failure assessment (SOFA) score for the same patients. Materials and Methods: A prospective clinical study was undertaken over a period of 18 months including a total of 80 patients admitted in the ED-ICU of the Department of emergency medicine and the Multi-disciplinary ICU at a tertiary care hospital. Results: Out of the 80 patients admitted in the ED-ICU, both APACHE II scoring and SOFA scoring had a strong significant statistical relationship (p ≤ 0.01) by fisher exact test with the outcomes. When multivariate logistic regression analysis was done there was no strong significant statistical correlation between APACHE II (24 hour) and mortality (adjusted odds ratio, 1.09; 95% CI 0.90–1.31; p = 0.371) but SOFA score had a logit coefficient of 0.53 and a high value on the Wald test =3.92 and hence a stronger statistical correlation with mortality (p = 0.048). Conclusion: We can conclude that SOFA score is better than APACHE score purely as a predictor of mortality and that SOFA score and cardiac events during stay in the ED-ICU are both individual predictors of mortality.

Keywords: APACHE II, SOFA, ED-ICU, Mortality


Corresponding Author : Ravikanti Karthik