Role of APACHE score in predicting mortality in chest ICU.

OBJECTIVE To determine the first 24 hours mean values of APACHE II score for two outcomes (alive or dead) in patients admitted in chest ICUs. METHODS A prospective study was conducted in the Department of Chest, Jinnah Postgraduate Medical Centre Hospital, Karachi from January 2009 to December 2009. Patients of all ages and either gender admitted in chest ICU for any cause, were consecutively enrolled. All patients with incomplete records and missing variables including laboratory investigations or who had not been followed up due to any reason were excluded. Patients who were readmitted in the ICU were also excluded. The main outcomes were the first 24 hours mean APACHE II score of the sample and first 24 hours mean APACHE II score of patients who were later discharged or had died. RESULTS The mean age of the patients was 53.16 +/- 19.29 years. Out of 143 participants 84 (58.7%) were males and 59 (41.3%) females. The main diagnosis included COPD with acute exacerbation 63 (44.05%), post TB fibrosis 17 (11.88%), acute severe asthma 14 (9.79%) and pneumonia 12 (8.39%) patients. The results found that 63 out of 143 patients were alive whereas 80 patients died. The mean APACHE II score on first 24 hours was 20.09 +/- 7.49. The mean 24 hours APACHE II score of patients who were discharged and who died was 18.93 +/- 7.19 and 22.33 +/- 7.80 respectively. CONCLUSION Our preliminary results showed that it is recommended to determine the cut off levels of APACHE II scores in patients admitted with chest ICU.