Skip to main content

Advertisement

Volume 3 Supplement 1

ESICM LIVES 2015

The apache ii and serum sodium levels as predictors of mortality in the surgical critically ill patients

Article metrics

  • 286 Accesses

  • 1 Citations

Introduction

The body sodium imbalance (dysnatremias) may be associated with increased mortality of critically ill patients. Evidence suggests that changes in the serum sodium level on admission to the intensive care unit (ICU), may lead to a poor outcome.

Objectives

The objective of this study was to evaluate the ability of APACHE II and serum sodium levels to predict mortality of surgical critically ill patients.

Methods

One hundred and ninety-five surgical patients (62 % males and 38% females; mean age of 51.8 ± 17.3 years) admitted to the ICU in the post-operative phase were retrospectively studied. The patients were divided into survivors (n=152) and nonsurvivors (n=43). APACHE II, and serum sodium levels at admission, 48-h and discharge were recorded. The capability of each index (APACHE II, Sodium-admission, sodium 48-h and sodium-discharge) to predict mortality of surgical patients was analysed by receiver-operator characteristic curves (ROC). Odds ratios (OR) and 95% confidence interval (CI) for hyponatremia (Na< 136 mmol/L) and hypernatremia (Na>144 mmol/L) were calculated.

Results

Comparison of data between survivors and nonsurvivors is summarized in Table 1. The mean APACHE II was 16.3 ± 8.3 (13.6 ± 6.1 for survivors and 25.5 ± 8.5 nonsurvivors). The area under the ROC curve for APACHE II was 0.841 (0.782-0.889) and 0.721 (0.653-0.783), 0.754 (0.687-0.812), 0.720 (0.651-0.782) for serum sodium level at admission, 48-h and discharge, respectively. OR for hyponatremia and hypernatremia were 5.33 (1.77-16.08) and 0.25 (0.1-0.65). The comparisons of ROC curves for these indexes are depicted in figure 1.

Table 1 Table 1
figure1

Figure 1

Conclusions

Even though APACHE II was the most effective index to predict mortality in the surgical critically ill patients, the serum sodium levels on admission may also be used as predictor of outcome.

References

  1. 1.

    Funk GC, Lindner G, Druml W, et al: Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010, 36 (2): 304-11. 10.1007/s00134-009-1692-0. Feb

  2. 2.

    Darmon M, Diconne E, Souweine B, et al: Prognostic consequences of borderline dysnatremia: Pay attention to minimal serum sodium change. Crit Care. 2013, 21:17 (1): R12-Jan

Download references

Author information

Correspondence to A Basile-Filho.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Basile-Filho, A., Menegueti, M., Nicolini, E. et al. The apache ii and serum sodium levels as predictors of mortality in the surgical critically ill patients. ICMx 3, A757 (2015) doi:10.1186/2197-425X-3-S1-A757

Download citation

Keywords

  • Public Health
  • Confidence Interval
  • Intensive Care Unit
  • Serum Sodium
  • Sodium Level