Supervisors info:
Αναστασία Κοτανίδου,Καθηγήτρια, Ιατρική, ΕΚΠΑ
Στυλιανός Ορφανός, Καθηγητής, Ιατρική, ΕΚΠΑ
Χριστίνα Μαρβάκη, Ομότιμη Καθηγήτρια, Πανεπιστήμιο Δυτικής Αττικής
Summary:
Introduction: Intensive Care Unit ( I.C.U.) is a hospital department, in which expertized staff provides urgent medical services to heavily impacted partients on twenty-hour basis, with the aim to restore their health and to improve quality of life. Rate of mortality of those patients is higher compared to that of patients who are nursed in any other hospital department and it depends not only on available sources and provision of care but also on significance and diagnosis of patients. The calibration of significance of the disease is carried via some systems, most significant of which is APACHE II and SAPS II. Scores computed from those systems are useful tools of medical and nursing staff of I.C.U., since they are relevant to conclusions about which of the parameters that are recorded when a patient is nursed in I.C.U., can be the cause or the factor of risk of increased mortality. So, high score indicates high mortality.
The purpose of subject clinical study is:
• The estimation of the systems of significance of disease APACHE II and SAPS II for all patients of General Hospital of Piraeus ‘‘Tzanio’’, in a period of a year and the record of mortality of subject patients within 28 days from the day of their admission in I.C.U.
• The investigation which of the data, that are included in the estimation of scores, constitute causes for the increase of mortality of patients in I.C.U.
• An effort for further investigation of the factors which could influence mortality (age, sex, diagnosis of importation).
Subject of this clinical study was 200 patients, who were imported in I.C.U. of General Hospital of Piraeus ‘‘Tzanio’’. The method that were used for the statistical analysis of above data is the multifactorial analysis, for which statistical analysis software package SPSS( statistic version 19) was used and as statistical significance was defined p>0,05.
The conclusions drawn by the statistical analysis is the below:
• 37,5% of patients taking part in this study were women and 62,5% were men
• Patients’ average age was estimated at 58,02, average APACHE II score at 22,33% and average SAPS II score at 37,03%. Furthermore, from those patients, 51, 5% had medical issues, 25,5% had surgical issues and 23% had an injury.
• From the sample of 200 patients, 68% survived (exit from hospital) and 32% was dead.
• the surface below ROC curve for the prediction of death based on APACHE II score was estimated at 0,748( 95% confidence internal : 0.684-0.808, p<0.001)
The result of subject clinical study is that the mortality of 28 days in a polyvalent I.C.U. (General Hospital of Piraeus ‘‘Tzanio’’) is influenced by APACHE II score and not by SAPS II score, neither by age, sex or diagnosis.
Keywords:
APACHE II,SAPS II, Mortality, ICU
