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
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
[21]  
Jeger R.V., Harkness S.M., Ramanathan K., Et al., Emergency revascularization in patients with cardiogenic shock on admission: a report from the SHOCK trial and registry, Eur Heart J, 27, pp. 664-670, (2006)
[22]  
Joulin O., Petillot P., Labalette M., Et al., Cytokine profile of human septic shock serum inducing cardiomyocyte contractile dysfunction, Physiol Res, 56, pp. 291-297, (2007)
[23]  
Knaus W.A., Draper E.A., Wagner D.P., Et al., APACHE II: a severity of disease classification system, Crit Care Med, 13, pp. 818-829, (1985)
[24]  
Knaus W.A., Wagner D.P., Draper E.A., Et al., The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults, Chest, 100, pp. 1619-1636, (1991)
[25]  
Le Gall J.R., Lemeshow S., Saulnier F., A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study, JAMA, 270, pp. 2957-2963, (1993)
[26]  
Mark B., Zahn R., Donges K., Et al., Current use and outcomes of intraaortic balloon counterpulsation in routine cardiology, Med Klin (Munich), 95, pp. 429-434, (2000)
[27]  
Markgraf R., Deutschinoff G., Pientka L., Et al., Performance of the score systems Acute Physiology and Chronic Health Evaluation II and III at an interdisciplinary intensive care unit, after customization, Crit Care, 5, pp. 31-36, (2001)
[28]  
Menon V., Slater J.N., White H.D., Et al., Acute myocardial infarction complicated by systemic hypoperfusion without hypotension: report of the SHOCK trial registry, Am J Med, 108, pp. 374-380, (2000)
[29]  
Menon V., White H., Lejemtel T., Et al., The clinical profile of patients with suspected cardiogenic shock due to predominant left ventricular failure: a report from the SHOCK Trial Registry. Should we emergently revascularize Occluded Coronaries in cardiogenic shocK?, J Am Coll Cardiol, 36, pp. 1071-1076, (2000)
[30]  
Metnitz P.G., Valentin A., Vesely H., Et al., Prognostic performance and customization of the SAPS II: results of a multicenter Austrian study, Simplified Acute Physiology Score. Intensive Care Med, 25, pp. 192-197, (1999)