Mortality discrimination in acute myocardial infarction: comparison between APACHE III and SAPS II prognosis systems. PAEEC Group.
OBJECTIVE
To compare the Acute Physiology, Age and Chronic Health Evaluation (APACHE) III with the Simplified Acute Physiology Score (SAPS II) in discriminating in-hospital mortality for intensive care unit (ICU) patients with acute myocardial infarction (AMI).


METHODS
Prospective, observational, multicenter study.


METHODS
70 Spanish ICUs.


METHODS
1711 patients with AMI and representative of Spanish ICUs.


RESULTS
APACHE III score, APACHE III system probability of death (APACHE III probability), SAPS II score and in-hospital mortality were noted for each patient. Two hundred and twenty three (13.0 %) patients died in the hospital. The sensitivity (+/- SE), specificity (+/- SE), and accuracy (+/- SE) for the APACHE III score were, respectively, 75.8 +/- 2.9, 75.9 +/- 1.1, and 75.9 +/- 1.0. The corresponding figures for APACHE III probability were 75.3 +/- 2.9, 79.2 +/- 1.1, and 78.7 +/- 1.0, and for SAPS II 72.2 +/- 3.0, 75.9 +/- 1.1, and 75.4 +/- 1.0.


CONCLUSIONS
The results indicate good discrimination by the three tests. APACHE III probability shows a statistically significant improvement in accuracy and specificity when compared with the two scores.
Reina
A
A
Servicio de Medicina Crítica y Urgencias, Hospital Virgen de las Nieves, Granada, Spain.
Vázquez
G
G
Aguayo
E
E
Bravo
I
I
Colmenero
M
M
Bravo
M
M
D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain; D018709:Statistics, Nonparametric