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Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong

Man, Shin Yan, Chan, Ka Man, Wong, Fung Yi, Wong, Kit Yi, Yim, Chi Lap, Mak, Paulina S.K., Kam, Chak Wah, Lau, Chor Chiu, Lau, Fei Lung, Graham, Colin A. and Rainer, Timothy Hudson 2007. Evaluation of the performance of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system for critically ill patients in emergency departments in Hong Kong. Resuscitation 74 (2) , pp. 259-265. 10.1016/j.resuscitation.2006.12.015

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Abstract

Introduction Numerous prognostic predictive models have been developed for critically ill patients, many of which are primarily designed for use in intensive care units. The objective of this study was to evaluate the accuracy of a modified Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in predicting the mortality for critically ill patients managed in emergency department (ED) resuscitation rooms in Hong Kong. Method A multi-centre, prospective study was conducted for patients managed in the resuscitation rooms of the EDs of four major hospitals, including one university teaching hospital. The primary outcome measure was 14 day all-cause mortality and the secondary outcome measure was the length of stay in hospital. Results Of 867 patients recruited between 4 and 30 April 2004, 106 (12.2%) patients died. The modified APACHE II score was found to be significantly higher in non-survivors compared to survivors (mean ± S.D.: 21.2 ± 7.7 versus 14.4 ± 7.1, p < 0.001). The area under the curve for modified APACHE II in predicting mortality was 0.743 (95% CI, 0.696–0.790). Conclusion The modified APACHE II score is only a moderate predictor of mortality for critically ill patients managed in the resuscitation rooms of EDs in Hong Kong. A more ED specific scoring method is required.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Resuscitation; Critical condition; Mortality prediction
Publisher: Elsevier
ISSN: 0300-9572
Date of Acceptance: 18 December 2006
Last Modified: 04 Jun 2017 09:15
URI: http://orca-mwe.cf.ac.uk/id/eprint/92849

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