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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

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

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Indian Journal of Emergency Medicine 5(4):p 225-232, October-December 2019. | DOI: DOI: http://dx.doi.org/10.21088/ijem.2395.311X.5419.2

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Hariprasad Kanakapura Veerendranath, Ravikanti Karthik, Murali Mohan NT, et al. 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. Indian J Emerg Med. 2019;5(4):225–232

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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

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Hariprasad Kanakapura Veerendranath, Ravikanti Karthik, Murali Mohan NT, et al. 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. Indian J Emerg Med. 2019;5(4):225–232

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

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