A Comparison of Severity Systems APACHE II and SAPS II in Critically ill Patients

  • Mohammad Omar Faruq Professor of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Mohammad Rashed Mahmud ICU Incharge, Ibn Sina Hospital Sylhet Ltd
  • Tanjima Begum Statistitian, BIRDEM General Hospital
  • ASM Areef Ahsan Asso. Professor, Department of Critical Care Medicine, BIRDEM General Hospital & Consultant, Intensive Care Unit, Ibn Sina Hospital, Dhanmondi, Dhaka
  • Kaniz Fatema Assistant Professor, Department of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Fatema Ahmed Junior Consultant, Department of Critical Care Medicine, BIRDEM General Hospital & Consultant, Intensive Care Unit, Renaissance Hospital & Research Institute Ltd., Dhanmondi, Dhaka
  • Md Rezaul Karim ICU Incharge, Ibn Sina Hospital, Dhaka
Keywords: Severity of illness, Intensive care, Mortality prediction, Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II)

Abstract

Objective: To assess the performance of Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II) in Bangladeshi critically ill patients.

Material and Method: Prospective observational cohort study conducted between January 1, 2008 and December 31, 2008 in the Intensive Care Unit (ICU) of BIRDEM Hospital, an 600-beds tertiary referral Postgraduate hospital and October to December 2008 in ICU, Ibn Sina Hospital Dhaka.

Results: One hundred ninety four patients were enrolled. There were 58 deaths (42.65%) at ICU discharge. APACHE II and SAPS II predicted hospital mortality 35.32 ± 21.81and 37.11 ± 27.34 respectively. Both models showed excellent discrimination. The overall discriminatory capability, as measured by the aROC, was generally good for two models and ranged from 0.78 to 0.89. APACHE II is slightly better compared to SAPS II score but not significantly better than SAPS II. Both systems exhibited good calibration ( = 8.304, p = 0.40 for APACHE II, = 9.040, p = 0.34 for SAPS II). Hosmer- Lemeshow goodness-of-fit test revealed a good performance for APACHE II scores.

Conclusion: APACHE II provided better performance than SAPS II in predicting mortality in our ICU patients but SAPS II also performed well. Our observed mortality was similar with the predicted mortality from APACHE II and SAPS II scores, which suggests that the result of this study reveals good intensive care quality.

DOI: http://dx.doi.org/10.3329/bccj.v1i1.14362

Bangladesh Crit Care J March 2013; 1: 27-32

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Abstract
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Published
2013-03-30
How to Cite
Faruq, M., Mahmud, M., Begum, T., Ahsan, A., Fatema, K., Ahmed, F., & Karim, M. R. (2013). A Comparison of Severity Systems APACHE II and SAPS II in Critically ill Patients. Bangladesh Critical Care Journal, 1(1), 27-32. https://doi.org/10.3329/bccj.v1i1.14362
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Original Articles