Utility of the APACHE IV, PPI, and combined APACHE IV with PPI for predicting overall and disease-specific ICU and ACU mortality.

摘要: BACKGROUND The Acute Physiology and Chronic Health Evaluation (APACHE) IV Palliative Performance Index (PPI) are scales commonly used to assess prognosis in intensive care units (ICUs) acute (ACUs). OBJECTIVE To compare the utility of APACHE IV, PPI, combined with PPI for predicting overall disease-specific mortality. DESIGN This is a prospective cohort study using admission data during first 24 hours. Chi-square contingency tables were analyze mortality each scale. SETTING was conducted at community hospital. PATIENTS Participants admitted between December 24, 2008 April 2, 2010. RESULTS plus (n = 599) significant (P < .0001 each). also patients congestive heart failure (CHF), pulmonary edema (PULEDEM), stroke (cerebrovascular accident [CVA]), terminal or metastatic cancer (CA), dementia. PULEDEM, CA, dementia but not CVA CHF, while all diseases CVA. most robust ICU/ACU improved specificity predict caused decline sensitivity. LIMITATIONS Limitations due subjective nature Glasgow Coma scale (GCS), differences illness trajectories, lack reliable follow-up participants. CONCLUSION benefits combining best exemplified participants Inconsistencies predictive value specific participant populations likely difference trajectories disease processes.