title: Predictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI: APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II.
abstract: BACKGROUND
  Scoring systems in critical care patients are essential for prediction of outcome and for evaluation of therapy. In this study we determined the value of the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scoring systems in the prediction of mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI).
  
  
  METHODS
  In this prospective, observational study, patients who were admitted to the ICU with CS complicating AMI were consecutively included. Data for the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scores were recorded on admission and during the following 96 h. Receiver operating characteristic curve analyses and the area under the curve (AUC) were used to estimate the predictive ability (mortality) of the scoring systems on admission and the maximum value.
  
  
  RESULTS
  Mortality among the 41 patients included in this study was 44 %. On admission, the mean APACHE II (p = 0.035), APACHE III (p = 0.003), SAPS II (p = 0.001), and SOFA (p = 0.042) scores were significantly higher in nonsurvivors than in survivors. At maximum score, APACHE II (p = 0.009), APACHE III (p < 0.001), and SAPS II (p < 0.001) appeared to have higher significance. On admission, the discrimination for APACHE III was 0.786, for SAPS II 0.790, and for APACHE II 0.691. The maximum-score AUC for APACHE II was 0.726, for APACHE III 0.827, and for SAPS II 0.832. Elebute-Stoner and SOFA did not yield valuable results at maximum score or, in the case of Elebute-Stoner, on admission.
  
  
  CONCLUSIONS
  These results suggest that at the time of diagnosis and at maximum value, the SAPS II, APACHE III, and APACHE II scores may be useful in predicting a high probability of survival of patients with CS complicating AMI.
authors.affiliation: Department of Medicine III, Martin Luther University, Halle-Wittenberg, Halle/Saale, Germany, patrick.kellner@medizin.uni-halle.de.
authors.forename: P
authors.initials: P
authors.lastname: Kellner
authors.forename: R
authors.initials: R
authors.lastname: Prondzinsky
authors.forename: L
authors.initials: L
authors.lastname: Pallmann
authors.forename: S
authors.initials: S
authors.lastname: Siegmann
authors.forename: S
authors.initials: S
authors.lastname: Unverzagt
authors.forename: H
authors.initials: H
authors.lastname: Lemm
authors.forename: S
authors.initials: S
authors.lastname: Dietz
authors.forename: J
authors.initials: J
authors.lastname: Soukup
authors.forename: K
authors.initials: K
authors.lastname: Werdan
authors.forename: M
authors.initials: M
authors.lastname: Buerke
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D055815:Young Adult
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