Scoring systems for predicting outcomes of critically ill patients in northeastern Thailand.

Abstract

The Acute Physiology and Chronic Health Evaluation System (APACHE) III, the APACHE II, the Simplified Acute Physiology Score (SAPS), and the Therapeutic Intervention Scoring System (TISS), calculated within the first 24 hours of admission, were compared in 209 critically ill patients admitted to the regional hospital in northeastern Thailand. Eighty-five (40.7%) patients subsequently died. The nonsurvivors had significantly higher APACHE III, APACHE II, SAPS and TISS scores than the survivors. ROC curves drawn for each severity index were in a discriminating position. There were no significant differences either among the areas under the ROC curves drawn for APACHE III, APACHE II, SAPS, and TISS, or among the overall accuracies of these indices. All four scoring system correlated well with the short-term prognosis, ie the mortality outcome, of critically ill patients. APACHE III, APACHE II, SAPS, and TISS appeared to be comparable to predictors of severity of critical illness. Selection of a severity indicator will depend on the resources available.