Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit
Study design: a descriptive, prospective cohort study. Objectives: identify the risk factors associated with SAPS 3 and APACHE II score to improve mortality prediction in elderly admitted in the intensive care unit (ICU). Methodology: a cohort study with 174 elderly patients admitted in ICU from Jul...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | Portuguese |
| Published: |
Universidade de São Paulo
2019-12-01
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| Series: | Medicina |
| Subjects: | |
| Online Access: | http://www.revistas.usp.br/rmrp/article/view/150661 |
| _version_ | 1828533423801630720 |
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| author | Marcus Vinícius Ferraz de Lucena Marcelo Antônio Oliveira Santos-Veloso Geylson Rodrigo dos Santos Xavier Inácio Borges Ferreira Felipe de Castro Moraes Renata Amorim de Lucena Letícia Amorim de Lucena Brivaldo Markman Filho Sandro Gonçalves de Lima |
| author_facet | Marcus Vinícius Ferraz de Lucena Marcelo Antônio Oliveira Santos-Veloso Geylson Rodrigo dos Santos Xavier Inácio Borges Ferreira Felipe de Castro Moraes Renata Amorim de Lucena Letícia Amorim de Lucena Brivaldo Markman Filho Sandro Gonçalves de Lima |
| author_sort | Marcus Vinícius Ferraz de Lucena |
| collection | DOAJ |
| description | Study design: a descriptive, prospective cohort study. Objectives: identify the risk factors associated with SAPS 3 and APACHE II score to improve mortality prediction in elderly admitted in the intensive care unit (ICU). Methodology: a cohort study with 174 elderly patients admitted in ICU from July 2016 to June 2017. The primary independent variables analyzed were: presence of stress hyperglycemia, the need for invasive mechanical ventilation (IMV), acute renal failure, level of consciousness and use of vasopressors. The outcomes studied were death and hospital discharge. Results: ICU and hospital mortality were 17.8% and 29.8%, respectively. The multivariate analysis of factors associated with hospital death not contemplated in the obtaining of SAPS 3 demonstrated that IMV, Chronic Obstructive Pulmonary Disease (COPD) and Mean Arterial Pressure (MAP) <70 mmHg improved the prediction of mortality. The Hosmer-Lemeshow test (p=0.472) and area under ROC curve=0.80 (CI95%:0.731-0.872) confirmed, respectively, an appropriate calibration and acceptable-to-excellent discriminatory power for this model. IMV and COPD were also factors associated with the APACHE II score in prediction of mortality with appropriated calibration (p=0.471) and acceptable-to-excellent discriminatory power (area under ROC curve=0.80 [CI95%:0.730-0.868]). Conclusion: IMV, COPD, and MAP <70 mmHg were associated with SAPS3 and APACHE II to predict mortality in elderly admitted to ICU. |
| first_indexed | 2024-12-11T23:10:27Z |
| format | Article |
| id | doaj.art-90ce8cc14da74f91970b766a311f8c94 |
| institution | Directory Open Access Journal |
| issn | 0076-6046 2176-7262 |
| language | Portuguese |
| last_indexed | 2024-12-11T23:10:27Z |
| publishDate | 2019-12-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-90ce8cc14da74f91970b766a311f8c942022-12-22T00:46:45ZporUniversidade de São PauloMedicina0076-60462176-72622019-12-0152410.11606/issn.2176-7262.v52i4p277-285Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unitMarcus Vinícius Ferraz de LucenaMarcelo Antônio Oliveira Santos-VelosoGeylson Rodrigo dos Santos XavierInácio Borges FerreiraFelipe de Castro MoraesRenata Amorim de LucenaLetícia Amorim de LucenaBrivaldo Markman FilhoSandro Gonçalves de LimaStudy design: a descriptive, prospective cohort study. Objectives: identify the risk factors associated with SAPS 3 and APACHE II score to improve mortality prediction in elderly admitted in the intensive care unit (ICU). Methodology: a cohort study with 174 elderly patients admitted in ICU from July 2016 to June 2017. The primary independent variables analyzed were: presence of stress hyperglycemia, the need for invasive mechanical ventilation (IMV), acute renal failure, level of consciousness and use of vasopressors. The outcomes studied were death and hospital discharge. Results: ICU and hospital mortality were 17.8% and 29.8%, respectively. The multivariate analysis of factors associated with hospital death not contemplated in the obtaining of SAPS 3 demonstrated that IMV, Chronic Obstructive Pulmonary Disease (COPD) and Mean Arterial Pressure (MAP) <70 mmHg improved the prediction of mortality. The Hosmer-Lemeshow test (p=0.472) and area under ROC curve=0.80 (CI95%:0.731-0.872) confirmed, respectively, an appropriate calibration and acceptable-to-excellent discriminatory power for this model. IMV and COPD were also factors associated with the APACHE II score in prediction of mortality with appropriated calibration (p=0.471) and acceptable-to-excellent discriminatory power (area under ROC curve=0.80 [CI95%:0.730-0.868]). Conclusion: IMV, COPD, and MAP <70 mmHg were associated with SAPS3 and APACHE II to predict mortality in elderly admitted to ICU.http://www.revistas.usp.br/rmrp/article/view/150661Prognostic FactorsMortalityElderlyIntensive Care UnitSAPS 3APACHE II |
| spellingShingle | Marcus Vinícius Ferraz de Lucena Marcelo Antônio Oliveira Santos-Veloso Geylson Rodrigo dos Santos Xavier Inácio Borges Ferreira Felipe de Castro Moraes Renata Amorim de Lucena Letícia Amorim de Lucena Brivaldo Markman Filho Sandro Gonçalves de Lima Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit Medicina Prognostic Factors Mortality Elderly Intensive Care Unit SAPS 3 APACHE II |
| title | Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit |
| title_full | Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit |
| title_fullStr | Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit |
| title_full_unstemmed | Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit |
| title_short | Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit |
| title_sort | mortality prognostic factors associated with saps 3 and apache ii in elderly patients admitted in intensive care unit |
| topic | Prognostic Factors Mortality Elderly Intensive Care Unit SAPS 3 APACHE II |
| url | http://www.revistas.usp.br/rmrp/article/view/150661 |
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