Comparison of acute physiology and chronic health evaluation ii and Glasgow coma score in predicting the outcomes of post anesthesia care unit's patients

ABSTRACT

Acute physiology and chronic health evaluation II [APACHE II] is one of the most general classification systems of disease severity in Intensive Care Units and Glasgow Coma Score [GCS] is one of the most specific ones. The aim of the current study was to assess APACHE II and GCS ability in predicting the outcomes [survivors, non-survivors] in the Post Anesthesia Care Unit's [PACU]. This was an observational and prospective study of 150 consecutive patients admitted in the PACU during 6-month period. Demographic information recorded on a checklist, also information about severity of disease calculated based on APACHE II scoring system in the first admission 24 h and GCS scale. Logistic regression, Hosmer-Lemeshow test and receiver operator characteristic [ROC] curves were used in statistical analysis [95% confidence interval]. Data analysis showed a significant statistical difference between outcomes and both APACHE II and Glasgow Coma Score [GCS] [P < 0.0001]. The ROC-curve analysis suggested that the predictive ability of GCS is slightly better than APACHE II in this study. For GCS the area under the ROC curve was 86.1% [standard error [SE] 3.8%], and for APACHE II it was 85.7% [SE 3.5%], also the Hosmer-Lemeshow statistic revealed better calibration for GCS [chi[2] = 5.177, P = 0.521], than APACHE II [chi[2] = 10.203, P = 0.251]. The survivors had significantly lower APACHE II and higher GCS compared with non-survivors, also GCS showed more predictive accuracy than APACHE II in prognosticating the outcomes in PACU