A Comparison of Acute Physiology and Chronic Health Evaluation III and Simplified Acute Physiology Score II in Predicting Sepsis Outcome in Intensive Care Unit

CONTEXT: Acute Physiology and Chronic Health Evaluation (APACHE) III and Simplified Acute Physiology Score (SAPS) II are frequently used to predict the outcome of Intensive Care Unit (ICU) patients of sepsis. AIM: The aim of the study was to compare the predictability of outcome with APACHE III and SAPS II score in ICU patients of sepsis, severe sepsis, and septic shock and the 28-day mortality. SETTINGS AND DESIGN: This study was an observational, prospective cohort study. MATERIALS AND METHODS: A total of 100 consecutive patients of sepsis were studied over 20 months. The worst physiological and biochemical parameters during the first 24 h were recorded for the scores and the patient's 28-day outcome followed up. STATISTICAL ANALYSIS USED: Continuous data were expressed as mean ± standard deviation or median. Receivers operating characteristic (ROC) curve was used to find the cutoff value, area under the curve, sensitivity and specificity of APACHE III score, and SAPS II score. Binary logistic regression with response variable as the outcome was utilized. P < 0.05 was considered statistically significant. RESULTS: The mean APACHE III score in the survivor group was 66.49 ± 18.56 as opposed to 80.67 ± 19.03 for nonsurvivors. The mean SAPS II score for the survivor group was 43.32 ± 13.02 as against the nonsurvivor group at 51.92 ± 12.34. The area under the ROC curve for APACHE III was 0.711 with 95% confidence interval as against 0.686 for SAPS II. The best cutoff value obtained for mortality prediction using the ROC curve was 69 for APACHE III while that for SAPS II was 49. CONCLUSIONS: APACHE III was found to be a better predictor of mortality as compared to SAPS II though the margin of difference in mortality prediction was not high.