SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit?

Korkmaz Toker, Melike; G�llero�lu, Aykan; Karabay, Ay�e G�l; Bi�er, �lhan G�ney; Demiraran, Yavuz

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SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit? [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2019; 25(3): 247-252 | DOI: 10.5505/tjtes.2018.22866

SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit?

Melike Korkmaz Toker¹, Aykan G�llero�lu², Ay�e G�l Karabay³, �lhan G�ney Bi�er⁴, Yavuz Demiraran⁵
¹Department of Anesthesiology and Reanimation, Mu�la S�tk� Ko�man University Training and Research Hospital, Mu�la-Turkey
²Department of Anesthesiology and Intensive Care Unit, Ba�kent University Ankara Hospital, Ankara-Turkey
³Department of Anesthesiology, Ota-Jine Med Private Hospital, �stanbul-Turkey
⁴Department of Anesthesiology and Reanimation, Osmaniye State Hospital, Osmaniye-Turkey
⁵Department of Anesthesiology and Reanimation, Medipol University Faculty of Medicine, �stanbul-Turkey

BACKGROUND: The aim of the present study was to evaluate the effectiveness of the Simplified Acute Physiology Score (SAPS) III and the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the prediction of in-hospital mortality in surviving multi-trauma patients.
METHODS: This study was conducted in the 13-bed intensive care unit (ICU) of a tertiary hospital. A retrospective review of multi-trauma patients whose care was managed in the ICU was performed. Data collection included details of age, gender, ICU admission, and outcome. APACHE IV and SAPS III scores, as well as the predicted mortality rate (PMR), were calculated using web-based calculators.
RESULTS: Of the 90 patients 20% (n=18) were female and 80% (n=72) were male. The overall mortality rate was 25.6%. The mean APACHE IV, Acute Physiology Score (APS) and SAPS III score was 69.27�34.51, 66.42�33.72, and 26.36�27.14, respectively. The mean PMR according to the APACHE IV and the SAPS III was 26.36�27.14 and 17.07�24.88, respectively. The area under the curve result of receiver operating characteristic curve analysis was 0.87 for the APACHE IV and 0.93 for the SAPS III.
CONCLUSION: The performance of the SAPS III was more sensitive and discriminative than the APACHE IV scoring system for multi-trauma ICU patients.

Keywords: Acute Physiology and Chronic Health Evaluation IV, intensive care unit; mortality; scoring systems; Simplified Acute Physiology Score III; trauma.

Yo�un bak�mdaki akut travma hastalar�nda hangi skoru se�meliyiz: SAPS III m�, APACHE IV m�?

Melike Korkmaz Toker¹, Aykan G�llero�lu², Ay�e G�l Karabay³, �lhan G�ney Bi�er⁴, Yavuz Demiraran⁵
¹Mu�la S�tk� Ko�man �niversitesi E�itim ve Ara�t�rma Hastanesi Anesteziyoloji ve Reanimasyon A.D, Mu�la, T�rkiye
²Ba�kent �niversitesi Ankara Hastanesi, Anesteziyoloji ve Yo�un Bak�m A.D, Ankara, T�rkiye
³Ota-Jine Med Hastanesi Anesteziyoloji Klini�i, �stanbul, T�rkiye
⁴Osmaniye Devlet Hastanesi Anesteziyoloji ve Reanimasyon Klini�i, Osmaniye, T�rkiye
⁵Medipol �niversitesi T�p Fak�ltesi, Anesteziyoloji ve Reaniamasyon A.D, �stanbul,T�rkiye

AMA�: �al��man�n amac�, hayatta kalan �oklu travma hastalar�nda basitle�tirilmi� akut fizyoloji skoru (SAPS) III ve akut fizyoloji ve kronik sa�l�k de�erlendirmesi (APACHE) IV��n mortaliteyi �ng�rmedeki etkinli�ini de�erlendirmektir.
GERE� VE Y�NTEM: Bu �al��ma ��nc� basamak bir hastanenin 13 yatakl� yo�un bak�m �nitesinde (YB�) ger�ekle�tirildi. YBܒde tedavi edilen �oklu travma hastalar�n�n geriye d�n�k bir incelemesi yap�ld�. Toplanan veriler ya�, cinsiyet, yo�un bak�m kabul ve yo�un bak�mdaki sonu�lar� i�eriyordu. APACHE IV, SAPS III ve �ng�r�len mortalite oran� web tabanl� bir hesap makinas�yla hesapland�.
BULGULAR: Doksan hastan�n %20�si (n=18) kad�n, %80�i (n=72) erkekti. Genel mortalite oran� %25.6 idi. APACHE IV, APS ve SAPS III puan ortalamalar� 69.27�34.51, 66.42�33.72 ve 26.36�27.14 bulundu. APACHE IV ve SAPS III�e g�re ortalama �ng�r�len mortalite oran� 26.36�27.14 ve 17.07�24.88 idi. E�rinin alt�ndaki alan (EAA) s�ras�yla APACHE IV ve SAPS III i�in 0.87, 0.93 idi.
TARTI�MA: �oklu travmal� yo�un bak�m hasta grubunda, SAPS III��n performans� APACHE IV skoruna g�re daha hassas ve ay�rt edicidir.

Anahtar Kelimeler: Akut fizyoloji ve kronik sa�l�k de�erlendirmesi IV, basitle�tirilmi� akut fizyoloji skoru III; mortalite; skorlama sistemleri; travma; yo�un bak�m �nitesi.

Melike Korkmaz Toker, Aykan G�llero�lu, Ay�e G�l Karabay, �lhan G�ney Bi�er, Yavuz Demiraran. SAPS III or APACHE IV: Which score to choose for acute trauma patients in intensive care unit?. Ulus Travma Acil Cerrahi Derg. 2019; 25(3): 247-252

Corresponding Author: Melike Korkmaz Toker, T�rkiye
Manuscript Language: English

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