Prediction of outcome in critically ill elderly patients using APACHE II and SOFA scores.
OBJECTIVE
Performances of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score were assessed in predicting mortality outcome in critically ill elderly patients.


METHODS
Mean APACHE II and SOFA scores were  compared in 106 intensive care unit patients aged > 65 years classified as survivors or deaths. The discriminatory ability of the scores was evaluated using the area under the receiver operating characteristic (ROC) curve. Calibration was assessed using the Hosmer-Lemeshow test.


RESULTS
Mean APACHE II and SOFA scores in survivors were lower than in those who died. There was a positive correlation between the APACHE II and SOFA scores. The area under the ROC curve was 0.76 for the APACHE II score and ranged from 0.74 for the initial SOFA score to 0.98 for the maximum SOFA  score. Hosmer-Lemeshow values for the APACHE II score and various SOFA scores indicated that predictions based on these scores closely fit the observed outcomes.


CONCLUSIONS
APACHE II and SOFA scores can accurately predict mortality outcome in critically ill elderly patients, especially  the maximum SOFA score and the difference between the maximum and initial SOFA scores.
Department of Nephrology, First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu Province 215006, China. papersub@sina.com
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D018806:APACHE; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012372:ROC Curve; D018570:Risk Assessment