Predictive value of outcome scores in patients suffering from cardiogenic shock complicating AMI: APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II; [Prädiktiver Wert von Risikoscores bei Patienten im kardiogenen Schock nach akutem Myokardinfarkt: APACHE II, APACHE III, Elebute-Stoner, SOFA und SAPS II]

被引：0
作者：
Kellner P. [1 ,2 ]
Prondzinsky R. [1 ]
Pallmann L. [1 ]
Siegmann S. [1 ,2 ]
Unverzagt S. [1 ,3 ]
Lemm H. [1 ]
Dietz S. [1 ]
Soukup J. [2 ]
Werdan K. [1 ]
Buerke M. [1 ]
机构：
[1] Department of Medicine III, Martin Luther University, Halle-Wittenberg, Halle/Saale
[2] Department of Anaesthesiology and Surgical Critical Care, Martin Luther University, Halle-Wittenberg, 06120 Halle/Saale
[3] Department of Biometrics and Statistics (SU), Martin Luther University, Halle-Wittenberg, Halle/Saale
来源：
Medizinische Klinik - Intensivmedizin und Notfallmedizin | 2013年 / 108卷 / 8期
关键词：
APACHE II; APACHE III; Cardiogenic shock; SAPS II; Scoring; Sepsis score according to Elebute and Stoner; SOFA;
D O I：
10.1007/s00063-013-0234-2
中图分类号：
学科分类号：
摘要：
Background: Scoring systems in critical care patients are essential for prediction of outcome and for evaluation of therapy. In this study we determined the value of the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scoring systems in the prediction of mortality in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI). Material and methods: In this prospective, observational study, patients who were admitted to the ICU with CS complicating AMI were consecutively included. Data for the APACHE II, APACHE III, Elebute-Stoner, SOFA, and SAPS II scores were recorded on admission and during the following 96 h. Receiver operating characteristic curve analyses and the area under the curve (AUC) were used to estimate the predictive ability (mortality) of the scoring systems on admission and the maximum value. Results: Mortality among the 41 patients included in this study was 44 %. On admission, the mean APACHE II (p = 0.035), APACHE III (p = 0.003), SAPS II (p = 0.001), and SOFA (p = 0.042) scores were significantly higher in nonsurvivors than in survivors. At maximum score, APACHE II (p = 0.009), APACHE III (p < 0.001), and SAPS II (p < 0.001) appeared to have higher significance. On admission, the discrimination for APACHE III was 0.786, for SAPS II 0.790, and for APACHE II 0.691. The maximum-score AUC for APACHE II was 0.726, for APACHE III 0.827, and for SAPS II 0.832. Elebute-Stoner and SOFA did not yield valuable results at maximum score or, in the case of Elebute-Stoner, on admission. Conclusion: These results suggest that at the time of diagnosis and at maximum value, the SAPS II, APACHE III, and APACHE II scores may be useful in predicting a high probability of survival of patients with CS complicating AMI. © 2013 Springer-Verlag Berlin Heidelberg.
引用
收藏
页码：666 / 674
页数：8
相关论文
共 44 条
[1]  
Antman E.M., Anbe D.T., Armstrong P.W., Et al., ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction
[2]  
a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction), J Am Coll Cardiol, 44, (2004)
[3]  
Babaev A., Frederick P.D., Pasta D.J., Et al., Trends in management and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock, Jama, 294, pp. 448-454, (2005)
[4]  
Birkeland J.A., Sejersted O.M., Taraldsen T., Et al., EC-coupling in normal and failing hearts, Scand Cardiovasc J, 39, pp. 13-23, (2005)
[5]  
Bohnen J.M., Mustard R.A., Schouten B.D., Steroids, APACHE II score, and the outcome of abdominal infection, Arch Surg, 129, pp. 33-37, (1994)
[6]  
Buerke M., Russ M., Werdan K., Cardiogenic shock in myocardial infarction: revascularization, mechanical support and pharmacotherapy, Dtsch Med Wochenschr, 133, pp. 2516-2521, (2008)
[7]  
Buerke M., Schwertz H., Langin T., Et al., Proteome analysis of myocardial tissue following ischemia and reperfusion-effects of complement inhibition, Biochim Biophys Acta, 1764, pp. 1536-1545, (2006)
[8]  
Carson S.S., Bach P.B., Predicting mortality in patients suffering from prolonged critical illness: an assessment of four severity-of-illness measures, Chest, 120, pp. 928-933, (2001)
[9]  
de Cassia Braga Ribeiro K., Kowalski L.P., APACHE II, POSSUM, and ASA scores and the risk of perioperative complications in patients with oral or oropharyngeal cancer, Arch Otolaryngol Head Neck Surg, 129, pp. 739-745, (2003)
[10]  
Elebute E.A., Stoner H.B., The grading of sepsis, Br J Surg, 70, pp. 29-31, (1983)
12345