Age influences the predictive value of Acute Physiology and Chronic Health Evaluation II and Intensive Care National Audit and Research Centre scoring models in patients admitted to Intensive Care Units after in-hospital cardiac arrest.

D. N. S. Senaratne (Lead / Corresponding author), T. Veenith

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Introduction: Outcomes following in‑hospital cardiac arrest (IHCA) are generally poor
though different patient populations may benefit to different degrees from admission to
Intensive Care Units (ICUs). Risk stratification algorithms may be useful in identifying
patients who are most likely to benefit from ICU admission and so may aid allocation of
this scarce resource. We aimed to compare the performance of the Acute Physiology and
Chronic Health Evaluation II (APACHE II) and Intensive Care National Audit and Research
Centre (ICNARC) scoring systems in predicting outcome following ICU admission after
IHCA in younger (≤69 years) and older (≥70 years) patients. Materials and Methods:
We performed a retrospective observational study in two adult ICUs from January
2006 to February 2010 inclusive. Patients were divided into younger (≤69 years) and
older (≥70 years) patients. The primary outcome measures were acute hospital mortality
and area under the curve (AUC) calculation for receiver operating characteristic (ROC)
analysis. Results: Two hundred and sixty‑one adult consecutive adult patients admitted
following IHCA. Hospital mortality was 58.6%. ROC analysis demonstrated that ICNARC
was more accurate than APACHE II in predicting acute hospital outcomes in the adult
population (AUC 0.734 vs. 0.706). Both scoring systems performed weaker when predicting
outcomes in younger patients compared to older patients (ICNARC AUC 0.655 vs. 0.810;
APACHE II AUC 0.660 vs. 0.759). Discussion: Both APACHE II and ICNARC predict
outcome well in older patients. In younger patients, their value is less clear, and so they
must be used with caution.
Original languageEnglish
Pages (from-to)155-158
Number of pages4
JournalIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
Volume19
Issue number3
DOIs
Publication statusPublished - Mar 2015

Keywords

  • Acute Physiology and Chronic Health Evaluation II
  • in‑hospital cardiac arrest
  • Intensive Care National Audit and Research Centre

Fingerprint

Dive into the research topics of 'Age influences the predictive value of Acute Physiology and Chronic Health Evaluation II and Intensive Care National Audit and Research Centre scoring models in patients admitted to Intensive Care Units after in-hospital cardiac arrest.'. Together they form a unique fingerprint.

Cite this