THE PROGNOSTIC IMPORTANCE OF APACHE III SYSTEM IN THE SURGICAL INTENSIVE CARE UNIT

Abstract

With this prospective study, we aim to determine whether scoring on the APACHE III score can predict the development of mortality in critically ill surgical patients. Many prognostic systems were used for this way. In these systems, the effects of the type and severity of the disease, physiological status and age of the patients, responses to the therapy were evaluated and tried to estimate the prognosis of the patients. APACHE III prognostic scoring system is one of these systems developed for the same is effective in predicting the mortality rates. During a one-year period, 150 patients were evaluated prospectively with APACHE III at surgical intensive care unit at university of Çukurova. Student t test and chi square test were used in evaluating the relations between APACHE III score and age of the patients, duration of hospital stay and the rate of morbidity and mortality. The statistical significance was found between the increased APACHE III scores and the rate of the mortality (P<0.05). The mean age of the survivors were 49 ± 17.9 year-old and 60 ± 13.8 year-old for non- survivors. The mean APACHE III scores was 31.5 ± 15.8year-old for survivors,.56.2 ± 16year-old for non-survivors. For both survivors and non-survivors ,the statistical significance was found with increased age. Our hospital is the single of tertiary reference hospital around its region, therefore all of the critically ill patients were referred to this hospital. All of the mortal patients were sent postoperatively, in spite of the insufficient number of the nurses and supplementary personel was seen to effect the increased rate of the mortality. It was concluded that APACHE III scoring system can be used for prediction of the severity of the diseases and standartization of clinical researchs in surgical care unit. It was accepted that the coordinance and multidisciplinary approach of the doctors ,nurses and supplementary personel in the intensive care unit is the most important factor of the prognosis of the patients.