Perbandingan Validitas Sistem Penilaian APACHE II, SOFA, dan CSOFA Sebagai Prediktor Mortalitas Pasien yang Dirawat di Instalasi Rawat Intensif RSUP H. Adam Malik Medan

Abstract

The APACHE II and SOFA scoring systems are still used as the objective instruments for predicting mortality in patients admitted to the Intensive Care Unit (ICU); however, the two are still considered less practical. CSOFA, with more practical parameters as well as a lower cost, is expected to provide better accuracy. The purpose of this study was to get a simpler, easier, and cheaper alternative, but with good accuracy, to APACHE II and SOFA as a predictor of mortality in patients admitted to the ICU of H. Adam Malik (HAM) Hospital. A cross-sectional diagnostic test study was conducted in February–April 2016 at the ICU of H. Adam Malik General Hospital. A sample of 71 adult patients that met the inclusion criteria was assessed by APACHE II, SOFA, and CSOFA at the first 24 hours after treatment. The mortality was then observed at the end of treatment. Statistical analysis using 2x2 tables and receiving operating curve (ROC) were used to calculate the sensitivity, specificity, positive, and negative predictive values, as well as the likelihood ratio using SPSS ver.23. CSOFA in this study presented a very good ability in predicting mortality with an Area under ROC (AuROC) of 87.6% while APACHE II had a good ability in predicting mortality with an AuROC of 84.7%. SOFA had sufficient ability in predicting mortality with an AuROC of 79.1%. In conclusion, CSOFA scoring system can be used as a patient mortality predictor as an alternative to APACHE II and SOFA in the ICU.

Keywords

• APACHE II
• CSOFA
• mortality
• SOFA