PMID: 20648099Jul 22, 2010Paper

Illness severity scoring for Intensive Care at Middlemore Hospital, New Zealand: past and future

The New Zealand Medical Journal
Susan L MannAnthony B Williams

Abstract

The Acute Physiological and Chronic Health Evaluation (APACHE) II score is a popular illness severity scoring system for intensive care units. Scoring systems such as the APACHE II allow researchers and clinicians to quantify patient illness severity with a greater degree of accuracy and precision, which is critical when evaluating practice patterns and outcomes, both within or between intensive care units. The study aims to: assess changes in APACHE II scores and hospital-standardised mortality ratio at our ICU over a nine year period from 1 January 1997 to 31 December 2005; assess for changes in the performance of the APACHE II scoring system in predicting patient hospital mortality over the same period; and assess for any clinical subgroups in which APACHE II scoring was particularly inaccurate or imprecise. Retrospective audit of a single centre relational database, with evaluation of the APACHE II scoring system by year through discrimination (ability to discriminate between the patients who will die or survive at hospital discharge) using receiver operating characteristic (ROC) curves, and calibration (ability to predict mortality rate over classes of risk) using goodness-of-fit as assessed by the Hosmer-Lemeshow statisti...Continue Reading

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