title: Performance assessment of the Simplified Acute Physiology Score II, the Acute Physiology and Chronic Health Evaluation II score, and the Sequential Organ Failure Assessment score in predicting the outcomes of adult patients with hepatic portal venous gas in the ED.
abstract: OBJECTIVE
  This study aims to evaluate the performance of Simplified Acute Physiology Score II (SAPS II), the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and the Sequential Organ Failure Assessment (SOFA) score for predicting illness severity and the mortality of adult hepatic portal venous gas (HPVG) patients presenting to the emergency department (ED). This will assist emergency physicians in risk stratification.
  
  
  METHODS
  Data for 48 adult HPVG patients who visited our ED between December 2009 and December 2013 were analyzed. The SAPS II, APACHE II score, and SOFA score were calculated based on the worst laboratory values in the ED. The probability of death was calculated for each patient based on these scores. The ability of the SAPS II, APACHE II score, and SOFA score to predict group mortality was assessed by using receiver operating characteristic curve analysis and calibration analysis.
  
  
  RESULTS
  The sensitivity, specificity, and accuracy were 92.6%,71.4%, and 83.3%, respectively, for the SAPS II method; 77.8%, 81%, and 79.2%, respectively, for the APACHE II scoring system, and 77.8%, 76.2%, and 79.2%, respectively, for the SOFA score. In the receiver operating characteristic curve analysis, the areas under the curve for the SAPS II, APACHE II scoring system, and SOFA score were 0.910, 0.878, and 0.809, respectively.
  
  
  CONCLUSIONS
  This is one of the largest series performed in a population of adult HPVG patients in the ED. The results from the present study showed that SAPS II is easier and more quickly calculated than the APACHE II and more superior in predicting the mortality of ED adult HPVG patients than the SOFA. We recommend that the SAPS II be used for outcome prediction and risk stratification in adult HPVG patients in the ED.
authors.affiliation: Department of Emergency Medicine, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chen-June
authors.initials: CJ
authors.lastname: Seak
authors.affiliation: Department of Emergency Medicine, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: ngowl@ms3.hinet.net.
authors.forename: Chip-Jin
authors.initials: CJ
authors.lastname: Ng
authors.affiliation: Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: David Hung-Tsang
authors.initials: DH
authors.lastname: Yen
authors.affiliation: College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Lin-Kou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Yon-Cheong
authors.initials: YC
authors.lastname: Wong
authors.affiliation: Laboratory for Epidemiology, Department of Health Care Management, and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. Electronic address: khsu@mail.cgu.edu.tw.
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
authors.affiliation: Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Joanna Chen-Yeen
authors.initials: JC
authors.lastname: Seak
authors.affiliation: Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Chen-Ken
authors.initials: CK
authors.lastname: Seak
mesh_terms: D018806:APACHE; D000368:Aged; D004618:Embolism, Air / Q000175:diagnosis* / Q000401:mortality; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D063305:Organ Dysfunction Scores; D063868:Patient Outcome Assessment; D011169:Portal Vein; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index