Abstract

AbstractOBJECTIVE: was to compare APACHE IV and APACHE II scoring methods for patients admitted in an ICU with ALI and ARDS.
METHODOLOGY: This comparative study was conducted in ICU, Lady Reading Hospital Peshawar, Pakistan from June 2011 to November 2012. All diagnosed cases of ALI/ARDS were included in the study after fulfilling inclusion criteria. Observed mortality rates were compared with Predicted mortality rates for both the APACHE IV and APACHI II scoring systems, standardized mortality ratio (SMR), sensitivity and specificity were determined. The mortality percentages were predicted via APACHI IV method and compared with the observed data. Data was analyzed with SPSS Vs.16. Chi Square test was applied to compare the qualitative variables.
RESULTS: There were 47 patients in the study, with a mean age in years for Male was 35+16.82, while 34+17.35 for Female. The overall mortality observed was 32% in all patients (15/47). APACHE IV predicted mortality rate sensitivity and specificity were 94.73% and 93.74% respectively, SMR of 0.94 and diagnostic value was 93.62%. APACHE II predicted mortality sensitivity and specificity were 100% and 87%, SMR of 0.79 and diagnostic value was 91%.
CONCLUSION: We conclude that the APACHE IV scoring system is equally sophisticated as the APACHE II system in predicting mortality rate in ICU patients with ALI/ARDS. APACHE IV score (score>90) gives probably additional reliable prediction of high possibility of death in patients with ALI/ARDS than APACHE II (score>25). Supplementary comprehensive research work is needed in excellence of our conclusion with matching ICUs and distinct diseases.Key words: APACHE IV, APACHE II, Intensive Care Unit, Mortality prediction, ALI, ARDS