A comparative study of APACHE II and SOFA scoring systems in critically ill patients with sepsis in MICU in tertiary care hospital

Author(s): Sathyan Elangovan1, Jercy Grace1, Jegan Mohan1, Sivagamasundari Venugopal2, Appandraj Srivijayan1
1Department of General Medicine, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India.
2Department of Paediatrics, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research, Melmaruvathur, Tamil Nadu, India.
Copyright © Sathyan Elangovan, Jercy Grace, Jegan Mohan, Sivagamasundari Venugopal, Appandraj Srivijayan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Sepsis and septic shock are among the leading causes of death and the most common cause of death among critically ill patients. Severity scores and prognostic models are used to evaluate the severity of illness in patients in the critical care unit. The present study aimed to compare the APACHE II and SOFA scoring systems in critically ill patients with sepsis in the medical ICU of a tertiary hospital.
Materials and Methods: The present study was a prospective observational study conducted on patients aged > 18 years, of either gender, admitted to the medical ICU for sepsis. All patients were evaluated using the APACHE II and SOFA scoring systems.
Results: The present study included 225 cases that met the study criteria. The mean age was 59.2 \(\pm\) 12.3 years, the mean length of stay was 9.3 \(\pm\) 4.2 days, and the mean length of ICU stay was 7.3 \(\pm\) 3.7 days. The majority of the patients were male (63.56%). The mortality rate was 58.22%, 39.56% of patients had multiple organ dysfunction, 74.22% were diagnosed with septic shock, and positive blood culture was noted among 34.67% of patients. On the day of admission, a significantly higher APACHE II score was noted among non-survivors (23.8 \(\pm\) 11.65) compared to survivors (16.59 \(\pm\) 8.24). The daily SOFA score was higher among non-survivors than survivors, and the difference was statistically significant (p < 0.001). Both APACHE II and SOFA scoring systems were found to be equivalent in predicting mortality in patients diagnosed with sepsis, and there was no statistical significance.
Conclusion: The APACHE II and SOFA scoring systems are equivalent in predicting mortality in patients diagnosed with sepsis, and there was no statistical significance.

Keywords: SOFA score; APACHE II score; Non-survivors; Sepsis; ICU admission.