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  • Anaesthesiol Intensive Ther · Jul 2014

    The effectiveness of the APACHE II, SAPS II and SOFA prognostic scoring systems in patients with haematological malignancies in the intensive care unit.

    • Wioletta Sawicka, Radosław Owczuk, Magdalena Anna Wujtewicz, and Maria Wujtewicz.
    • Chair and Department of Anaesthesiology and Intensive Therapy, Medical University of Gdańsk, Poland. wsawicka@gumed.edu.pl.
    • Anaesthesiol Intensive Ther. 2014 Jul 1;46(3):166-70.

    BackgroundCancer-related mortality remains the second most common cause of death in Poland. In many cases, the occurrence of treatment-related complications requires admission to the intensive care unit (ICU). The aim of this study was to assess the clinical application of the APACHE II, SAPS II and SOFA scales to evaluate the risk of death in patients with haematological malignancies treated in the ICU.MethodsThis study's analysis included 99 patients, who were each assigned to one of the following two groups: surviving patients who were discharged from the ICU (n = 24); and patients who died in the ICU (n = 75). Analysis was performed using demographic, clinical and laboratory data obtained during the patient's admission to the ICU and also during the first 24 hours of intensive therapy. Patient assessment was performed using the APACHE II, SAPS II and SOFA scoring systems as well as other clinical variables.ResultsUnivariate logistic regression identified the following risk factors of death in patients with haematological malignancies: systolic (P = 0.006), diastolic (P = 0.01) and mean arterial pressure values (P = 0.009); occurrence of acute kidney injury; neutrophil (P = 0.009) and platelet count in the peripheral blood (P = 0.001); and the SAPS II (P = 0.00005), SOFA (P = 0.00009) and APACHE II (P = 0.0007) scores. SAPS II score was the only independent risk factor of patient death in multivariate analysis (P = 0.0004; unitary OR 1.052 [95% CI: 1.022-1.082]).ConclusionOf all the applied patient assessment scales, only the SAPS II score was found to be useful in subjects with haematological malignancies hospitalised in the ICU.

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