[Analysis of prognosis assessment with acute physiology and chronic health evaluation III, multiple organ dysfunction score and sequential organ failure assessment for the postoperative patients in cardiovascular surgery].
OBJECTIVE
To analyze the clinical significance of the prognosis assessment with acute physiology and chronic health evaluation III (APACHEIII), multiple organ dysfunction score (MODS) and sequential organ failure assessment (SOFA) for postoperative patients in cardiovascular surgery.


METHODS
Prognosis of 68 patients undergoing cardiovascular operation from February 2004 to June 2004 in our ward was assessed by APACHE III, MODS and SOFA. Then the scores were calculated and compared everyday while they stayed in Cardiac Surgery Intensive Care Unit (CSICU).


RESULTS
The scores of three methods showed no significant difference from one another in the first three postoperative days, but were significantly higher than all the scores calculated just after the entrance to the CSICU (A0, M0, S0; all P<0.01). There were no differences in the changes of APACHE III, MODS and SOFA(DeltaA, DeltaM and DeltaS) in the first three postoperative days respectively, although they all showed a decreasing tendency. APACHE III scores were positively correlated with MODS although the correlation were diminishing (P<0.01 at first day but P<0.05 at third day), while they were positively correlated with SOFA only in the first two days (both P<0.01). The MODS was positively correlated with SOFA at various time points (P<0.001). The length of stay in CSICU was positive correlated with A0 and maximum of APACHEIII (Amax, P<0.05), and M0, maximum of MODS (Mmax) as well as S0, maximum of SOFA (Smax, P<0.001), respectively.


CONCLUSIONS
For the patients who have undergone cardiovascular operation, A0 could assess the prognosis fairly precisely, but MODS and SOFA assessment seem to be better than APACHE III. Individual Smax and kinetic DeltaS might be the most suitable indexes for cardiovascular surgery.
Cui
Hu-jun
HJ
Department of Cardiac Surgery, First Hospital, Peking University, Beijing 100034, China.
Xin
Wei-qiang
WQ
Tan
Yan-fen
YF
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D013504:Cardiovascular Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis*; D011184:Postoperative Period; D011379:Prognosis; D055815:Young Adult