Acute physiology and chronic health evaluation II score at presentation predict mortality in critically Ill COVID-19 patients: A retrospective observational study

Abstract

Background: A scoring system to predict patient's prognosis may aid clinicians in deciding patient's treatment continuation. This study aimed to investigate the reliability of Acute Physiology and Chronic Health Evaluation (APACHE) II score in predicting mortality in critically ill COVID-19 patients in intensive care unit (ICU). Patients and Methods: This retrospective observational study included the data from medical records of critically ill patients from April to November 2020. The collected data were patient's identity, age, gender, comorbid, Glasgow coma scale (GCS) score, temperature, mean arterial pressure, heart rate, hematocrit, leukocyte, natrium, kalium, serum creatinine, blood pH, PaO2 level, and history of organ insufficiency or immunocompromised within 24 h after ICU admission. Patient's outcome (survival and nonsurvival) was recorded. Results: A total of 120 patients were included in the study. APACHE II score was significantly higher in nonsurvival compared to survival group (19.12 vs. 12.33; P < 0.001). The area under curve value was 0.955 (P < 0.001) which indicated APACHE II score as a good predictive value for mortality. The cutoff value of the APACHE II score for mortality prediction in this study was 15, with sensitivity, specificity, positive prediction value, negative prediction value, and accuracy of 94%, 79.4%, 80.6%, 94.3%, and 86.7%, respectively. GCS score, heart rate, age, and serum kalium level were related to mortality. Conclusion: The APACHE II score is reliable in predicting mortality in critically ill COVID-19 patients in ICU.

Keywords

• acute physiology and chronic health evaluation ii
• coronavirus
• critical illness
• intensive care
• mortality
• prognosis