The accuracy of APACHE II in hemorrhagic stroke patients and SAPS II in ischemic stroke patients was superior in predicting mortality


It is studied the applicability of the Acute Physiology and Chronic Health Evaluation II ( APACHE II ) and Simplified Acute Physiology Score II ( SAPS II ) in patients admitted to the intensive care unit ( ICU ) with acute stroke and compared the results with the Glasgow Coma Scale ( GCS ) and National Institutes of Health Stroke Scale ( NIHSS ).
A comparative study of accuracy for predicting hemorrhagic and ischemic stroke mortality was also conducted.

From 2011 to 2012, ischemic or hemorrhagic stroke patients admitted to the ICU were included in the study. Overall 498 patients were included in this study.

APACHE II and SAPS II-predicted mortalities were compared using a calibration curve, the Hosmer-Lemeshow goodness-of-fit test, and the receiver operating characteristic ( ROC ) curve, and the results were compared with the GCS and NIHSS.

The observed mortality was 26.3%, whereas APACHE II and SAPS II-predicted mortalities were 35.12% and 35.34%, respectively.

The mean GCS and NIHSS scores were 9.43 and 21.63, respectively.

The calibration curve was close to the line of perfect prediction. The ROC curve showed a slightly better prediction of mortality for APACHE II in hemorrhagic stroke patients and SAPS II in ischemic stroke patients.

The GCS and NIHSS were inferior in predicting mortality in both patient groups.

Although both the APACHE II and SAPS II systems can be used to measure performance in the neurosurgical ICU setting, the accuracy of APACHE II in hemorrhagic stroke patients and SAPS II in ischemic stroke patients was superior. ( Xagena )

Moon BH et al, J Clin Neurosci 2014; Epub ahead of print

XagenaMedicine_2014



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