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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access

Validation of acute physiology and chronic health evaluation (APACHE) IV score in a korea provincial icus by comparing korean simplified acute physiology score (SAPS) III

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Intensive Care Medicine Experimental20153 (Suppl 1) :A335

https://doi.org/10.1186/2197-425X-3-S1-A335

  • Published:

Keywords

  • Intensive Care Unit
  • Hospital Mortality
  • Academic Medical Center
  • Simplified Acute Physiology Score
  • Acute Physiology Score

Introduction

The Simplified Acute Physiology Score (SAPS) III has been validated as the Korea SAPSIII model in Korea. However, the Acute Physiology and Chronic Health Evaluation (APACHE) IV model has not yet been validated in Korea provincial intensive care units (ICUs).

Objectives

The aim of this study was to compare the ability of the APACHE IV with Korean SAPS 3 in predicting hospital mortality in a provincial ICU population.

Methods

The study was designed as a prospective cohort study for patients admitted to the nine intensive care units in the four provincial academic medical centers from September 2013 to February 2014. Validation and comparison were conducted to measure discrimination and calibration with using the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow test, respectively.

Results

Among 733 enrolled patients, 34.4% (252/733) were surgical patients. The hospital mortality was 23.5%. The median APACHE IV score was 71(Standard deviation ± 33.8), and the predicted death rate was 25.6% respectively. The observed hospital mortality was 23.5%. The discriminative powers of two models were similar. The AUCs were 0.753 (95% confidence intervals (CI) : 0.711-0.794) for APAPCH IV and 0.768 (95% CI : 0.727-0.809) for Korean SAPS III respectively. Hosmer-Lemeshow C and H statics showed good calibration for both models, (H = 8.69, p = 0.370; C = 128.17, p = 0.824 for APACHE IV, and H = 8.40, p = 0.396; C = 178.98, p < 0.001 for Korean SAPS III respectively).

Conclusions

For Korea regional ICU patients, the APACHE IV and Korea SAPS III showed good discrimination and good calibration for hospital mortality. Therefore, the APACHE IV prognostic model might be applied to predict mortality in Korea regional ICUs.

Authors’ Affiliations

(1)
Internal Medicine, Chungnam National Univ. Hospital, Daejeon, Korea, Republic of Korea
(2)
Clinical Trials Center, Chungnam National Univ. Hospital, Daejeon, Korea, Republic of Korea
(3)
Daejeon Regional Emergency Center, Chungnam National University Hospital, Daejeon, Korea, Republic of Korea
(4)
Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea, Republic of Korea
(5)
Chungju Hospital, Konkuk University School of Medicine, Internal Medicine, Chungju, Korea, Republic of Korea
(6)
Internal Medicine, Chungbuk National Univ. Hospital, Cheongju, Korea, Republic of Korea
(7)
Internal Medicine, Konyang University Hospital, Daejeon, Korea, Republic of Korea

References

  1. So Yeon Lim, et al: Validation of SAPS3 Admission Score and Its Customization for Use in Korean ICU Patients: A Prospective Multicenter Study. Respirology. 2013, 18 (6): 989-995.View ArticleGoogle Scholar
  2. Jae Yeol Kim, et al: External Validation of the Acute Physiology and Chronic Health Evaluation II in Korean Intensive Care Units. Yonsei Med J. 2013, 54 (2): 425-431.View ArticleGoogle Scholar
  3. Hosmer DW, Lemeshow S: Confidence interval estimates of an index of quality performance based on logistic regression models. Stat Med. 1995, 14: 2161-2172.PubMedView ArticleGoogle Scholar
  4. Hannah Lee, et al: Validation of the APACHE IV model and its comparison with the APACHE II, SAPS 3, and Korean SAPS 3 models for the prediction of hospital mortality in a Korean surgical intensive care unit. Korean J Anesthesiol. 2014, 67: 115-122.View ArticleGoogle Scholar

Copyright

© Moon et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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