• N S Rocchetti, J J Egea-Guerrero, Z Ruiz de Azua-Lopez, L Martin-Villen, A Rodriguez-Rodriguez, A Vilches-Arenas, E Correa-Chamorro, C J Settecase, and D H Bagilet.
• Hospital Eva Peron, Granadero Baigorria, Argentina.
• Rev Neurol. 2018 Aug 16; 67 (4): 121-128.

AimTo assess the prognostic value of APACHE II and SAPS II scales to predict brain death evolution of neurocritical care patients.Patients And MethodsRetrospective observational study performed in a tertiary hospital. Include 508 patients over 16 years old, hospitalized in ICU for at least 24 hours. The variables of interest were: demographic data, risk factors, APACHE II, SAPS II and outcome.ResultsMedian age: 41 years old (IR: 25-57). Males: 76.2%. Most frequent reason for admission: trauma (55.3%). Medians: Glasgow Coma Scale (GCS), 10 points; APACHE II, 13 points; SAPS II, 31 points; and ICU stay, 5 days. Mortality in the ICU was 28.5% (n = 145) of whom 44 (8.7%) evolved to brain death. Univariate logistic regression analysis showed that GCS, APACHE II and SAPS II scores, as well as ICU stay days behaved as predictors of brain death evolution. However, the multivariate analysis performed including APACHE II and SAPS II scores showed that only APACHE II maintained statistical significance, despite the good discrimination of both scores.ConclusionTransplant coordinators might use the APACHE II score as a tool to detect patients at risk of progression to brain death, minimizing the loss of potential donors.

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