A Prospective Observational Study on Use of Acute Physiology and Chronic Health Evaluation-II and Sequential Organ Failure Assessment Score to Predict Outcome

  • Niraj Kumar Keyal Department of General Practice and Emergency Medicine-Critical Care Medicine Unit, National Medical College, Birgunj, Nepal https://orcid.org/0000-0001-8587-1718
  • Sudhakar Jha Department of Internal Medicine, National Medical College, Birgunj, Nepal
  • Shahnaj Parween Department of Anaesthesiology, National Medical College, Birgunj, Nepal
  • Ishfa Banu Haque Department of Oral and Maxillofacial Surgery, National Academy of Medical Sciences, Bir Hospital
  • Tauqueer Ansari Department of General Practice and Emergency Medicine-Critical Care Medicine Unit, National Medical College, Birgunj, Nepal
  • Istiyaque Ansari Department of General Practice and Emergency Medicine-Critical Care Medicine Unit, National Medical College, Birgunj, Nepal.
DOI: https://doi.org/10.33314/jnhrc.v23i01.5560

Abstract

Background: Acute physiology and chronic health evaluation –II (APACHE-II) and Sequential organ failure assessment (SOFA) is used to predict overall mortality and sepsis outcome in the intensive care unit (ICU) respectively. There are limited studies that have shown that both score can be used to predict mortality in surgical and medical patients admitted in the intensive care unit.

Methods: It was a prospective, observational study in a level three intensive care unit of National Medical College, Birgunj. This study was conducted in 542 patients admitted in the mixed intensive care unit of medical; college. Demographic data was gathered from each patient in the preformed sheet at the time of presentation to the intensive care unit. Outcome of patients was recorded in terms of mortality, discharge toward and leave against medical advice. The descriptive data are presented as the number and percentage for categorical data and mean ± standard deviation for continuous data according to their distribution

Results: Five hundred forty two patients were included in this study. 340(62.7%) were males and 202(37.3%) were females. 440(81%) patients survived and went home, 65(12%) expired, 26(5%) left the hospital against medical advice (LAMA) and 11(2%) gave do not resuscitate orders (DNR). The discrimination power was similar for APACHE II and SOFA scores (AUC=0.732 versus 0.771, respectively, p>0.05). APACHE II score>8.5 and SOFA >3.5 was cut off to predict mortality.

Conclusions: SOFA and APACHE II has similar discriminating power to predict mortality in all group of patients in a mixed intensive care unit.

Keywords: APACHE II; intensive care units; SOFA.

Published
2025-06-29
How to Cite
Keyal, N. K., Jha, S., Parween, S., Haque, I. B., Ansari, T., & Ansari, I. (2025). A Prospective Observational Study on Use of Acute Physiology and Chronic Health Evaluation-II and Sequential Organ Failure Assessment Score to Predict Outcome. Journal of Nepal Health Research Council, 23(01), 152-157. https://doi.org/10.33314/jnhrc.v23i01.5560
Issue
Vol. 23 No. 01 (2025): Issue 66 Jan-March, 2025
Section
Original Article

Copyright (c) 2025 Niraj Kumar Keyal, Sudhakar Jha, Shahnaj Parween, Ishfa Banu Haque, Tauqueer Ansari, Istiyaque Ansari

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Journal of Nepal Health Research Council JNHRC allows to read, download, copy, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose. Copyright is retained by author. The JNHRC work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).