The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital
Background The Acute Physiology and Chronic Health Evaluation (APACHE) II model has been widely used in Korea. However, there have been few studies on the APACHE IV model in Korean intensive care units (ICUs). The aim of this study was to compare the ability of APACHE IV and APACHE II in predicting...
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Korean Society of Critical Care Medicine
2017-08-01
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| Series: | Korean Journal of Critical Care Medicine |
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| Online Access: | http://www.kjccm.org/upload/pdf/kjccm-2016-00990.pdf |
| _version_ | 1817971175471448064 |
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| author | Jae Woo Choi Young Sun Park Young Seok Lee Yeon Hee Park Chaeuk Chung Dong Il Park In Sun Kwon Ju Sang Lee Na Eun Min Jeong Eun Park Sang Hoon Yoo Gyu Rak Chon Young Hoon Sul Jae Young Moon |
| author_facet | Jae Woo Choi Young Sun Park Young Seok Lee Yeon Hee Park Chaeuk Chung Dong Il Park In Sun Kwon Ju Sang Lee Na Eun Min Jeong Eun Park Sang Hoon Yoo Gyu Rak Chon Young Hoon Sul Jae Young Moon |
| author_sort | Jae Woo Choi |
| collection | DOAJ |
| description | Background The Acute Physiology and Chronic Health Evaluation (APACHE) II model has been widely used in Korea. However, there have been few studies on the APACHE IV model in Korean intensive care units (ICUs). The aim of this study was to compare the ability of APACHE IV and APACHE II in predicting hospital mortality, and to investigate the ability of APACHE IV as a critical care triage criterion. Methods The study was designed as a prospective cohort study. Measurements of discrimination and calibration were performed using the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test respectively. We also calculated the standardized mortality ratio (SMR). Results The APACHE IV score, the Charlson Comorbidity index (CCI) score, acute respiratory distress syndrome, and unplanned ICU admissions were independently associated with hospital mortality. The calibration, discrimination, and SMR of APACHE IV were good (H = 7.67, P = 0.465; C = 3.42, P = 0.905; AUROC = 0.759; SMR = 1.00). However, the explanatory power of an APACHE IV score >93 alone on hospital mortality was low at 44.1%. The explanatory power was increased to 53.8% when the hospital mortality was predicted using a model that considers APACHE IV >93 scores, medical admission, and risk factors for CCI >3 coincidentally. However, the discriminative ability of the prediction model was unsatisfactory (C index <0.70). Conclusions The APACHE IV presented good discrimination, calibration, and SMR for hospital mortality. |
| first_indexed | 2024-04-13T20:44:12Z |
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| issn | 2383-4870 2383-4889 |
| language | English |
| last_indexed | 2024-04-13T20:44:12Z |
| publishDate | 2017-08-01 |
| publisher | Korean Society of Critical Care Medicine |
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| series | Korean Journal of Critical Care Medicine |
| spelling | doaj.art-250ba8ebd4f04e118be405e524cfcca02022-12-22T02:30:45ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-48702383-48892017-08-0132327528310.4266/kjccm.2016.009901108The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary HospitalJae Woo Choi0Young Sun Park1Young Seok Lee2Yeon Hee Park3Chaeuk Chung4Dong Il Park5In Sun Kwon6Ju Sang Lee7Na Eun Min8Jeong Eun Park9Sang Hoon Yoo10Gyu Rak Chon11Young Hoon Sul12Jae Young Moon13 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Cheongju St. Mary’s Hospital, Cheongju, Korea Department of Nursing Care, Chungnam National University Hospital, Daejeon, Korea Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea Clinical Trial Center, Chungnam National University Hospital, Daejeon, Korea Department of Nursing Care, Chungnam National University Hospital, Daejeon, Korea Department of Nursing Care, Chungnam National University Hospital, Daejeon, Korea Department of Nursing Care, Chungnam National University Hospital, Daejeon, Korea Division of Pulmonology, Department of Internal Medicine, Chamjoeun Hospital, Gwangju, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Cheongju St. Mary’s Hospital, Cheongju, Korea Department of Surgery, Chungbuk National University College of Medicine, Cheongju, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, KoreaBackground The Acute Physiology and Chronic Health Evaluation (APACHE) II model has been widely used in Korea. However, there have been few studies on the APACHE IV model in Korean intensive care units (ICUs). The aim of this study was to compare the ability of APACHE IV and APACHE II in predicting hospital mortality, and to investigate the ability of APACHE IV as a critical care triage criterion. Methods The study was designed as a prospective cohort study. Measurements of discrimination and calibration were performed using the area under the receiver operating characteristic curve (AUROC) and the Hosmer-Lemeshow goodness-of-fit test respectively. We also calculated the standardized mortality ratio (SMR). Results The APACHE IV score, the Charlson Comorbidity index (CCI) score, acute respiratory distress syndrome, and unplanned ICU admissions were independently associated with hospital mortality. The calibration, discrimination, and SMR of APACHE IV were good (H = 7.67, P = 0.465; C = 3.42, P = 0.905; AUROC = 0.759; SMR = 1.00). However, the explanatory power of an APACHE IV score >93 alone on hospital mortality was low at 44.1%. The explanatory power was increased to 53.8% when the hospital mortality was predicted using a model that considers APACHE IV >93 scores, medical admission, and risk factors for CCI >3 coincidentally. However, the discriminative ability of the prediction model was unsatisfactory (C index <0.70). Conclusions The APACHE IV presented good discrimination, calibration, and SMR for hospital mortality.http://www.kjccm.org/upload/pdf/kjccm-2016-00990.pdfAPACHE IVcalibrationdiscriminationintensive care unitstriage. |
| spellingShingle | Jae Woo Choi Young Sun Park Young Seok Lee Yeon Hee Park Chaeuk Chung Dong Il Park In Sun Kwon Ju Sang Lee Na Eun Min Jeong Eun Park Sang Hoon Yoo Gyu Rak Chon Young Hoon Sul Jae Young Moon The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital Korean Journal of Critical Care Medicine APACHE IV calibration discrimination intensive care units triage. |
| title | The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital |
| title_full | The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital |
| title_fullStr | The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital |
| title_full_unstemmed | The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital |
| title_short | The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital |
| title_sort | ability of the acute physiology and chronic health evaluation apache iv score to predict mortality in a single tertiary hospital |
| topic | APACHE IV calibration discrimination intensive care units triage. |
| url | http://www.kjccm.org/upload/pdf/kjccm-2016-00990.pdf |
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