Objectives Find the discriminant and calibration of APACHE II (Acute Physiology And Chronic Health Evaluation) score to predict mortality for different type of intensive care unit (ICU) patients.
Methods This is a cohort retrospective study using secondary data of ICU patients admitted to Siloam Hospital of Lippo Village from 2014 to 2018 with minimum age ≥17 years. The analysis uses the receiver operating characteristic curve, student t-test and logistic regression to find significant variables needed to predict mortality.
Results A total of 2181 ICU patients: men (55.52%) and women (44.48%) with an average age of 53.8 years old and length of stay 3.92 days were included in this study. Patients were admitted from medical emergency (30.5%), neurosurgical (52.1%) and surgical (17.4%) departments, with 10% of mortality proportion. Patients admitted from the medical emergency had the highest average APACHE score, 23.14±8.5, compared with patients admitted from neurosurgery 15.3±6.6 and surgical 15.8±6.8. The mortality rate of patients from medical emergency (24.5%) was higher than patients from neurosurgery (3.5%) or surgical (5.3%) departments. Area under curve of APACHE II score showed 0.8536 (95% CI 0.827 to 0.879). The goodness of fit Hosmer-Lemeshow show p=0.000 with all ICU patients’ mortality; p=0.641 with medical emergency, p=0.0001 with neurosurgical and p=0.000 with surgical patients.
Conclusion APACHE II has a good discriminant for predicting mortality among ICU patients in Siloam Hospital but poor calibration score. However, it demonstrates poor calibration in neurosurgical and surgical patients while demonstrating adequate calibration in medical emergency patients.
- adult intensive & critical care
- intensive & critical care
Data availability statement
All data relevant to the study are included in the article. All data relevant to the study are included in the article or uploaded as supplementary information.
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Contributors Conception and designing research studies, have full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish:: VS, HH and BS. Data collection: HH, OET, AW and VP. Analysing data: VS, HH, BS and MKS. Interpretating the results: AAL, AW and VP. Critical revision of the article: TEBS, ACA and SS. Writing the manuscript: VS, HH and MKS.
Funding This work was supported by the Beasiswa Pendidikan Pasca Sarjana, Scholarship for Doctoral Programme, from the Ministry of Education, Republic of Indonesia.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.