title: Better prognostic marker in ICU - APACHE II, SOFA or SAP II!
abstract: OBJECTIVE
  This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients.
  
  
  METHODS
  This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model.
  
  
  RESULTS
  A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001).
  
  
  CONCLUSIONS
  All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.
authors.affiliation: Dr. Iftikhar Haider Naqvi, MBBS, FCPS. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Iftikhar Haider
authors.initials: IH
authors.lastname: Naqvi
authors.affiliation: Prof. Khalid Mahmood, MBBS, FCPS, FRCP(E), FRCP(G). Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Khalid
authors.initials: K
authors.lastname: Mahmood
authors.affiliation: Dr. Syed Ziaullah, MBBS, FCPS II Trainee. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Syed
authors.initials: S
authors.lastname: Ziaullaha
authors.affiliation: Dr. Syed Muhammad Kashif, MBBS, FCPS. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Syed Mohammad
authors.initials: SM
authors.lastname: Kashif
authors.affiliation: Dr. Asim Sharif, MBBS, FCPS II Trainee. Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Asim
authors.initials: A
authors.lastname: Sharif
keywords: Acute Physiology and Chronic Health Evaluation (APACHE II); Critically ill patients; ICU mortality; Simplified Acute Physiology Score (SAPS II). SOFA: Sequential Organ Failure Assessment