Year : 2015  |  Volume : 8  |  Issue : 3  |  Page : 294-300

Evaluation and comparison of the three scoring systems at 24 and 48 h of admission for prediction of mortality in an Indian ICU: a prospective cohort study

1 Department of Anaesthesiology, Pondicherry Institute of Medical Sciences, Puducherry, India
2 Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India

Correspondence Address:
Mohd Saif Khan
No. 3-A, D Block, PIMS Staff Quarters, P.I.M.S. Hospital, Kalapet, Puducherry - 605 014
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-7934.159003

Rights and Permissions

Introduction Predictive accuracy of severity scoring systems in Indian ICUs does not fit well owing to differences in case mix from the west. We hypothesized that 24 h is too early to predict the outcome and that the predictive accuracy of these scores might be better at 48 h of ICU admission. Objective The aim of this study was to evaluate and compare Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology (SAPS) II, and Sequential Organ Failure Assessment (SOFA) as a predictor of outcome in critically ill patients at 24 and at 48 h in a tertiary care hospital ICU. Patients and methods A prospective cohort study was conducted on 169 patients over 2 years at a single medical surgical ICU. Eighty-five critically ill patients were included. For each patient, APACHE II, SAPS II, and SOFA scores were calculated at two time frames (first at 24 and then at 48 h) after ICU admission. The accuracies and comparisons of outcome prediction by the three scores were assessed with standardized mortality ratio and area under the receiver operating characteristic (AUROC) curves. Results All scoring systems (except SOFA) underestimated the deaths (standardized mortality ratio>1). All scoring systems displayed larger AUROC curves at 48 h than those at 24 h. APACHE II 48 showed the largest AUROC of 0.933. Conclusion All scores performed better when calculated at 48 h rather than at 24 h. Overall, APACHE II 48 is the best predictor of 28-day mortality in critically ill patients. A worsening APACHE II score at 48 h after ICU admission may identify the patients at high risk of mortality.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded365    
    Comments [Add]    
    Cited by others 2    

Recommend this journal