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Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis

The Acute Physiology and Chronic Health Evaluation (APACHE) IV model can predict the intensive care unit (ICU) length of stay (LOS) in critically ill patients. Thus, this study aimed to validate the performance of the APACHE IV score in predicting ICU LOS among patients with sepsis. This retrospecti...

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Autores principales: Zangmo, Kinley, Khwannimit, Bodin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090054/
https://www.ncbi.nlm.nih.gov/pubmed/37041277
http://dx.doi.org/10.1038/s41598-023-33173-4
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author Zangmo, Kinley
Khwannimit, Bodin
author_facet Zangmo, Kinley
Khwannimit, Bodin
author_sort Zangmo, Kinley
collection PubMed
description The Acute Physiology and Chronic Health Evaluation (APACHE) IV model can predict the intensive care unit (ICU) length of stay (LOS) in critically ill patients. Thus, this study aimed to validate the performance of the APACHE IV score in predicting ICU LOS among patients with sepsis. This retrospective study was conducted in the medical ICU of a tertiary university between 2017 and 2020. A total of 1,039 sepsis patients were enrolled. Patients with an ICU stay of 1 and > 3 days accounted for 20.1% and 43.9%. The overall observed and APACHE IV predicted ICU LOS were 6.3 ± 6.5 and 6.8 ± 6.5, respectively. The APACHE IV slightly over-predicted ICU LOS with standardized length of stay ratio 0.95 (95% CI 0.89–1.02). The predicted ICU LOS based on the APACHE IV score was statistically longer than the observed ICU LOS (p < 0.001) and were poorly correlated (R(2) = 0.02, p < 0.001), especially in patients with a lower severity of illness. In conclusions the APACHE IV model poorly predicted ICU LOS in patients with sepsis. The APACHE IV score needs to be modified or we need to make a new specific model to predict ICU stays in patients with sepsis.
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spelling pubmed-100900542023-04-13 Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis Zangmo, Kinley Khwannimit, Bodin Sci Rep Article The Acute Physiology and Chronic Health Evaluation (APACHE) IV model can predict the intensive care unit (ICU) length of stay (LOS) in critically ill patients. Thus, this study aimed to validate the performance of the APACHE IV score in predicting ICU LOS among patients with sepsis. This retrospective study was conducted in the medical ICU of a tertiary university between 2017 and 2020. A total of 1,039 sepsis patients were enrolled. Patients with an ICU stay of 1 and > 3 days accounted for 20.1% and 43.9%. The overall observed and APACHE IV predicted ICU LOS were 6.3 ± 6.5 and 6.8 ± 6.5, respectively. The APACHE IV slightly over-predicted ICU LOS with standardized length of stay ratio 0.95 (95% CI 0.89–1.02). The predicted ICU LOS based on the APACHE IV score was statistically longer than the observed ICU LOS (p < 0.001) and were poorly correlated (R(2) = 0.02, p < 0.001), especially in patients with a lower severity of illness. In conclusions the APACHE IV model poorly predicted ICU LOS in patients with sepsis. The APACHE IV score needs to be modified or we need to make a new specific model to predict ICU stays in patients with sepsis. Nature Publishing Group UK 2023-04-11 /pmc/articles/PMC10090054/ /pubmed/37041277 http://dx.doi.org/10.1038/s41598-023-33173-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Zangmo, Kinley
Khwannimit, Bodin
Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis
title Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis
title_full Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis
title_fullStr Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis
title_full_unstemmed Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis
title_short Validating the APACHE IV score in predicting length of stay in the intensive care unit among patients with sepsis
title_sort validating the apache iv score in predicting length of stay in the intensive care unit among patients with sepsis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090054/
https://www.ncbi.nlm.nih.gov/pubmed/37041277
http://dx.doi.org/10.1038/s41598-023-33173-4
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