Acute and Critical Care

Original Articles

Pulmonary
Performance of APACHE IV in Medical Intensive Care Unit Patients: Comparisons with APACHE II, SAPS 3, 216 and MPM₀ III: Mihye Ko, Miyoung Shim, Sang-Min Lee, Yujin Kim, Soyoung Yoon; Acute Crit Care. 2018;33(4):216-221. Published online November 21, 2018; DOI: https://doi.org/10.4266/acc.2018.00178

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Background
In this study, we analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiology Score (SAPS) 3, and Mortality Probability Model (MPM)0 III in order to determine which system best implements data related to the severity of medical intensive care unit (ICU) patients.
Methods
The present study was a retrospective investigation analyzing the discrimination and calibration of APACHE II, APACHE IV, SAPS 3, and MPM0 III when used to evaluate medical ICU patients. Data were collected for 788 patients admitted to the ICU from January 1, 2015 to December 31, 2015. All patients were aged 18 years or older with ICU stays of at least 24 hours. The discrimination abilities of the three systems were evaluated using c-statistics, while calibration was evaluated by the Hosmer-Lemeshow test. A severity correction model was created using logistics regression analysis.
Results
For the APACHE IV, SAPS 3, MPM0 III, and APACHE II systems, the area under the receiver operating characteristic curves was 0.745 for APACHE IV, resulting in the highest discrimination among all four scoring systems. The value was 0.729 for APACHE II, 0.700 for SAP 3, and 0.670 for MPM0 III. All severity scoring systems showed good calibrations: APACHE II (chi-square, 12.540; P=0.129), APACHE IV (chi-square, 6.959; P=0.541), SAPS 3 (chi-square, 9.290; P=0.318), and MPM0 III (chi-square, 11.128; P=0.133).
Conclusions
APACHE IV provided the best discrimination and calibration abilities and was useful for quality assessment and predicting mortality in medical ICU patients.

Citations

Citations to this article as recorded by

Predicting Hospital Survival in Patients Admitted to ICU with Pulmonary Embolism
Martin J. Ryll, Aurelia Zodl, Toby N. Weingarten, Alejandro A. Rabinstein, David O. Warner, Darrell R. Schroeder, Juraj Sprung
Journal of Intensive Care Medicine.2024; 39(5): 455. CrossRef
Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit
U Ri Go, Sung-Hyun Cho
Journal of Korean Academy of Nursing Administration.2024; 30(1): 67. CrossRef
Utilidad del uso del modelo MPM-II para predecir riesgo de mortalidad en comparación con SAPS-II en pacientes adultos en la unidad de cuidados intensivos
Perla Marlene Guzmán Ramírez
Acta Médica Grupo Ángeles.2023; 21(2): 115. CrossRef
Plasma and Urinary Biomarkers Improve Prediction of Mortality through 1 Year in Intensive Care Patients: An Analysis from FROG-ICU
Beth A. Davison, Christopher Edwards, Gad Cotter, Antoine Kimmoun, Étienne Gayat, Agnieszka Latosinska, Harald Mischak, Koji Takagi, Benjamin Deniau, Adrien Picod, Alexandre Mebazaa
Journal of Clinical Medicine.2023; 12(9): 3311. CrossRef
Effects of prior antiplatelet and/or nonsteroidal anti-inflammatory drug use on mortality in patients undergoing abdominal surgery for abdominal sepsis
Se Hun Kim, Ki Hoon Kim
Surgery.2023; 174(3): 611. CrossRef
Extracorporeal blood purification is associated with improvement in biochemical and clinical variables in the critically‐ill COVID‐19 patients
Vedran Premužić, Jakša Babel, Danilo Gardijan, Ivana Lapić, Rajka Gabelica, Zvonimir Ostojić, Marin Lozić, Gordana Pavliša, Maja Hrabak, Josip Knežević, Dunja Rogić, Slobodan Mihaljević
Therapeutic Apheresis and Dialysis.2022; 26(2): 316. CrossRef
Relation between red blood cell distribution width and acute kidney injury in patients with sepsis
Marina Larissa Vettorello Ramires, Manoela Fidelis Batista Leite, Daniel Zu Yow Lo, Leonardo Bonilla da Silveira, Leonardo José Rolim Ferraz, Andreia Pardini, Araci Massami Sakashita, Andrea Tiemi Kondo, Guilherme Benfatti Olivato, Marcelino de Souza Durã
Einstein (São Paulo).2022;[Epub] CrossRef
Prediction of hospital mortality in intensive care unit patients from clinical and laboratory data: A machine learning approach
Elena Caires Silveira, Soraya Mattos Pretti, Bruna Almeida Santos, Caio Fellipe Santos Corrêa, Leonardo Madureira Silva, Fabrício Freire de Melo
World Journal of Critical Care Medicine.2022; 11(5): 317. CrossRef
Reduction in the rate of mortality of moderate to severe COVID 19 infected patients with the use of remdesivir - A Tertiary Care Hospital-based retrospective observational study
Mahima Lakhanpal, Debpriya Sarkar, Ritesh Kumar, Isha Yadav
Anesthesia: Essays and Researches.2022; 16(3): 296. CrossRef
Phase Angle and Frailty are Important Prognostic Factors in Critically Ill Medical Patients: A Prospective Cohort Study
S.J. Ko, J. Cho, S.M. Choi, Y.S. Park, C.-H. Lee, S.-M. Lee, C.-G. Yoo, Y.W. Kim, Jinwoo Lee
The Journal of nutrition, health and aging.2021; 25(2): 218. CrossRef
The use of chest ultrasonography in suspected cases of COVID-19 in the emergency department
Enrico Allegorico, Carlo Buonerba, Giorgio Bosso, Antonio Pagano, Giovanni Porta, Claudia Serra, Pasquale Dolce, Valentina Minerva, Ferdinando Dello Vicario, Concetta Altruda, Paola Arbo, Teresa Russo, Chiara De Sio, Nicoletta Franco, Gianluca Ruffa, Cinz
Future Science OA.2021;[Epub] CrossRef
Criticality: A New Concept of Severity of Illness for Hospitalized Children
Eduardo A. Trujillo Rivera, Anita K. Patel, James M. Chamberlain, T. Elizabeth Workman, Julia A. Heneghan, Douglas Redd, Hiroki Morizono, Dongkyu Kim, James E. Bost, Murray M. Pollack
Pediatric Critical Care Medicine.2021; 22(1): e33. CrossRef
Validation of the Acute Physiology and Chronic Health Evaluation (APACHE) II and IV Score in COVID-19 Patients
Jeroen Vandenbrande, Laurens Verbrugge, Liesbeth Bruckers, Laurien Geebelen, Ester Geerts, Ina Callebaut, Ine Gruyters, Liesbeth Heremans, Jasperina Dubois, Bjorn Stessel, Edward A Bittner
Critical Care Research and Practice.2021; 2021: 1. CrossRef
Relationship Between Mean Vancomycin Trough Concentration and Mortality in Critically Ill Patients: A Multicenter Retrospective Study
Yanli Hou, Jiajia Ren, Jiamei Li, Xuting Jin, Ya Gao, Ruohan Li, Jingjing Zhang, Xiaochuang Wang, Xinyu Li, Gang Wang
Frontiers in Pharmacology.2021;[Epub] CrossRef
Blood purification therapy with a hemodiafilter featuring enhanced adsorptive properties for cytokine removal in patients presenting COVID-19: a pilot study
Gianluca Villa, Stefano Romagnoli, Silvia De Rosa, Massimiliano Greco, Marco Resta, Diego Pomarè Montin, Federico Prato, Francesco Patera, Fiorenza Ferrari, Giuseppe Rotondo, Claudio Ronco
Critical Care.2020;[Epub] CrossRef

Infection
A Retrospective Study Investigating Risks of Acute Respiratory Distress Syndrome and Mortality Following Human Metapneumovirus Infection in Hospitalized Adults: Hyunjung Hwang, Yujin Kim, Jeong-Woong Park, Sung Hwan Jeong, Sun Young Kyung; Korean J Crit Care Med. 2017;32(2):182-189. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2017.00038

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Abstract PDF Supplementary Material

Background
Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported.
Methods
We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group.
Results
In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment.
Conclusions
These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.

Citations

Citations to this article as recorded by

A Case of Metapneumovirus Pneumonia-Related Acute Respiratory Distress Syndrome in a Young Adult Patient
Tae Wan Kim, Won-Young Kim
The Korean Journal of Medicine.2024; 99(2): 111. CrossRef
Human Metapneumovirus Pneumonia Precipitating Acute Respiratory Distress Syndrome in an Adult Patient
Dena H Tran, Muhammad Sameed, Ellen T Marciniak, Avelino C Verceles
Cureus.2021;[Epub] CrossRef
Outcomes of severe human metapneumovirus-associated community-acquired pneumonia in adults
Sang-Ho Choi, Sang-Bum Hong, Jin Won Huh, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Heungsup Sung, Hyun Jung Koo, Kyung-Hyun Do, Sang-Oh Lee, Chae-Man Lim, Yang Soo Kim, Jun Hee Woo, Younsuck Koh
Journal of Clinical Virology.2019; 117: 1. CrossRef

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