Journal of Medical and Surgical Intensive Care Medicine 2019 , Vol 10, Issue 3
Comparison of the Effectiveness of Acute Physiology and Chronic Health Evaluation II and Modified Early Warning Score Scoring Systems in Predicting Mortality in Patients in the Intensive Care Unit
Esra CAKIR 1 ,Esra SARI 1 ,Ahmet BINDAL 1 ,Ali ÇIFTÇI 1 ,Işıl ÖZKOÇAK TURAN 1
1University of Health Sciences, Ankara Numune Training and Research Hospital, Clinic of Anesthesiology and Intensive Care Unit, Ankara, Turkey DOI : 10.33381/dcbybd.2019.2129 Aim: The relationship between various clinical scoring systems and clinical outcomes has been evaluated in the emergency department and intensive care unit. This study aimed to evaluate the capacity of the Acute Physiology and Chronic Health Evaluation (APACHE II) score and the Modified Early Warning Score (MEWS) in predicting the mortality of patients admitted to the intensive care unit.

Material and Methods: All patients (aged >18 years) admitted to the intensive care unit between September 1, 2017 and December 31, 2018 were included in this study. Laboratory data and vital signs at the time of hospitalization were used to calculate the MEWS and APACHE II scores. The primary goal of the study was to evaluate the relationship between these scoring systems and mortality.

Results: In total, 665 patients were included in the study. The mortality rate was 34.2%. The area under the receiver operating characteristic curve for the APACHE II score was 0.783, whereas that for the MEWS was 0.924 (95% confidence interval: 0.750–0.814 vs 0.901–0.943, respectively, p = 0.0001 for both). The APACHE II score cutoff value for mortality was 18, whereas that for the MEWS was 5 (sensitivity: 87.89% vs 88.99%, 95% confidence interval: 68.7–80.4 vs 84.2–92.7; specificity: 68.49% vs 83.33%, 95% confidence interval: 63.9–72.8 vs 79.5–86.7).

Conclusion: Although the MEWS was superior to the APACHE II score, both systems were significantly effective in predicting mortality. Keywords : Intensive care unit, APACHE II, Mortality, Emergency