Application of the APACHE II score to assess the condition of patients with critical neurological diseases

Acta Neurol Belg. 2015 Dec;115(4):651-6. doi: 10.1007/s13760-014-0420-x. Epub 2015 Jan 8.

Abstract

The Acute Physiology And Chronic Health Evaluation II (APACHE II) scoring system has been commonly used to assess the severity of patients' diseases in general intensive care units (ICUs). However, few studies have investigated the application of this scoring system in patients in neurologic ICUs. In this study, the APACHE II scores of 102 patients in the neurologic ICU were calculated within the first 24 h. The actual mortality and predicted mortality were obtained based on these scores and analyzed statistically. The data indicated that cerebral hemorrhage, cerebral infarction and intracranial infection accounted for the top three causes for admission to the neurologic ICU, and these conditions were associated with high APACHE II scores and high predicted mortality. Additionally, the actual mortality rate was lower than the predicted rate after effective treatment. All patients were divided into groups according to their APACHE II scores, and we found that higher APACHE II scores were associated with higher actual mortality, especially for patients whose APACHE II scores were greater than 10. The APACHE II scores of the deceased patient group were higher than those of the surviving group, and this difference was statistically significant. In conclusion, our study found that the APACHE II scoring system may provide valuable information for predicting patient's condition and prognosis in neurologic ICUs.

Keywords: Acute physiology and chronic health evaluation II; Mortality; Neurologic intensive care unit; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Critical Illness*
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Nervous System Diseases / classification
  • Nervous System Diseases / diagnosis*
  • Prognosis
  • Severity of Illness Index*