Comparison of mortality prediction effect of APACHE II, APACHE IV, SAPS II and SAPS III scores in critical patients in the intensive care unit

The patients who hospitalized in intensive care units, disease severity indicators are used to predict mortality and morbidity and to guide their treatment. Therefore, various scoring systems have been studied for years. Acute Physiology and Chronic Health Evaluation (APACHE) and Simplified Acute Physiology Score (SAPS) are developed and among the most frequently used mortality prediction scores. In this study, Mortality prediction effect of APACHE II, APACHE IV, SAPS II and SAPS III scoring systems were investigated to predict the mortality of critical patients admitted to the Anesthesiology and Reanimation Clinic Intensive Care Unit. In this study, sample size determined and ethics committee approval was obtained. Retrospectively, 1183 patients were studied and 825 patients who provided the working criteria were included in the study. Patients' mortality relationships with demographic data and their clinical condition and acceptance locations was evaluated. Patients were divided into systemic diagnosis groups at the time of admission to intensive care. Of these groups, impact on mortality were compared statistically. The worst value for the first 24 hours of the patient data evaluated with APACHE II, APACHE IV, SAPS II and SAPS III scoring systems with the computer program. Predicted mortality rates and actual mortality rates were compared APACHE II, APACHE IV, SAPS II and SAPS III scores. In all tests, statistical significance P = 0.05 significance level and P = 0.01 further significance level were evaluated bi-directionally. Male gender, advanced age, more days of hospitalization, more days with mechanical ventilation, low Glaskow coma scale score, need for inotropic agents, and admission from in-hospital clinics parameters with mortality relationships were determined to be statistically significant. To predict the mortality determined markedly significant in patients who died the total score of each of the four scoring systems due to the higher (p <0.001). According to ROC analysis, mortality prediction success ranking was determined as SAPS III> SAPS II> APACHE II> APACHE IV. The highest specificity value was detected in the APACHE II scoring system. The highest sensitivity value was detected in SAPS II scoring system. It was determined to be statistically significant the effect of systemic diagnosis groups on mortality. The first three groups with high mortality rates were determined as respiratory system, cardiovascular system and central nervous system, respectively. Scoring systems used to predict mortality in intensive care patients are continuously updated to find the gold standard. We think that will make a significant contribution to the updating of scoring systems with the results of this study, In addition, this study also shows the need for new comprehensive studies to divided in subgroups of patients in the intensive care unit. Keywords: Intensive care unit, Mortality, APACHE score, SAPS score