Septic shock in a surgical intensive care--validation of multiorgan and APACHE II scores in predicting outcome.
We analysed retrospectively the records of 353 admissions to the National University Hospital's Surgical Intensive Care Unit over a one-year period and found 25 patients with septicaemic shock requiring vasoactive therapy. The mortality rate was 68%. Blood cultures were positive in only 36%. We validated the ability of the Acute Organ System Failure score, Multiorgan Failure score, Organ System Failure score and Acute Physiology and Chronic Health Evaluation II (APACHE II) score to predict outcome at onset of septic shock. Only the APACHE II was a significant predictor of outcome, the rest having poor predictive ability. We conclude that the present scoring systems are too inaccurate for us to base important clinical decisions on.
Chen
F G
FG
Department of Anaesthesia, National University of Singapore.
Koh
K F
KF
D018806:APACHE; D000367:Age Factors; D000368:Aged; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D016905:Gram-Negative Bacterial Infections / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D010351:Patient Discharge / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012772:Shock, Septic / Q000401:mortality*; D012846:Singapore / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome