Illness severity and prognosis assessment with acute physiology and chronic health evaluation II for patients after cardiovascular surgery / 中南大学学报(医学版)

ABSTRACT

OBJECTIVE@#To evaluate illness severity and to assess the prognosis with acute physiology and chronic health evaluation II (APACHE II) for patients after cardiovascular surgery.@*METHODS@#APACHE II scores of 234 patients in the cardiac surgical intensive care unit (CSICU) were calculated, and the actual mortality and the predicted mortality were obtained based on the score.@*RESULTS@#The APACHE II score of the 234 patients was 14.22±6.77. The difference in the APACHE II score between the survivors, the patients with complications and the death group was significant; the difference in the APACHE II score between patients with different preoperative cardiac functions was significant; the detention time in the CSICU was positively related to APACHE II scores; and the ROC area under the curve of APACHE II was 0.991±0.006. With the predicted rate >30% as the standard for death, sensitivity of APACHE II score for mortality risk prediction was 80.00%, specificity was 99.12%, and the accuracy was 98.72%. According to the score, we divided the patients into 3 groups (20 points), forecast mortality in the >20 point group was in the 95% confidence interval of actual mortality.@*CONCLUSION@#APACHE II is a good index for illness severity and prognosis assessment for patients after cardiovascular surgery.