Acute Physiologic and Chronic Health Examination II and Sequential Organ Failure Assessment Scores for Predicting Outcomes of Out-of-Hospital Cardiac Arrest Patients Treated with Therapeutic Hypothermia.
10.4266/kjccm.2014.29.4.288
- Author:
Sung Joon KIM
;
Yong Su LIM
;
Jin Seong CHO
;
Jin Joo KIM
;
Won Bin PARK
;
Hyuk Jun YANG
- Publication Type:Original Article
- Keywords:
acute physiologic and chronic health examination;
cardiopulmonary resuscitation;
hypothermia, induced;
organ dysfunction scores;
outcome assessment;
out-of-hospital cardiac arrest
- MeSH:
APACHE;
Area Under Curve;
Cardiopulmonary Resuscitation;
Hospital Mortality;
Humans;
Hypothermia*;
Hypothermia, Induced;
Intensive Care Units;
Logistic Models;
Odds Ratio;
Organ Dysfunction Scores*;
Out-of-Hospital Cardiac Arrest*;
Outcome Assessment (Health Care);
Retrospective Studies;
Survivors
- From:Korean Journal of Critical Care Medicine
2014;29(4):288-296
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to assess the relationship between acute physiologic and chronic health examination (APACHE) II and sequential organ failure assessment (SOFA) scores and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia (TH). METHODS: Out-of-hospital cardiac arrest (OHCA) survivors treated with TH between January 2010 and December 2012 were retrospectively evaluated. We captured all components of the APACHE II and SOFA scores over the first 48 hours after intensive care unit (ICU) admission (0 h). The primary outcome measure was in-hospital mortality and the secondary outcome measure was neurologic outcomes at the time of hospital discharge. Receiver-operating characteristic and logistic regression analysis were used to determine the predictability of outcomes with serial APACHE II and SOFA scores. RESULTS: A total of 138 patients were enrolled in this study. The area under the curve (AUC) for APACHE II scores at 0 h for predicting in-hospital mortality and poor neurologic outcomes (cerebral performance category: 3-5) was more than 0.7, and for SOFA scores from 0 h to 48 h the AUC was less than 0.7. Odds ratios used to determine associations between APACHE II scores from 0 h to 48 h and in-hospital mortality were 1.12 (95% confidence interval [CI], 1.03-1.23), 1.13 (95% CI, 1.04-1.23), and 1.18 (95% CI, 1.07-1.30). CONCLUSIONS: APACHE II, but not SOFA score, at the time of ICU admission is a modest predictor of in-hospital mortality and poor neurologic outcomes at the time of hospital discharge for patients who have undergone TH after return of spontaneous circulation following OHCA.
