• A Reina, G Vázquez, E Aguayo, I Bravo, M Colmenero, and M Bravo.
• Servicio de Medicina Crítica y Urgencias, Hospital Virgen de las Nieves, Granada, Spain.
• Intensive Care Med. 1997 Mar 1;23(3):326-30.

ObjectiveTo compare the Acute Physiology, Age and Chronic Health Evaluation (APACHE) III with the Simplified Acute Physiology Score (SAPS II) in discriminating in-hospital mortality for intensive care unit (ICU) patients with acute myocardial infarction (AMI).DesignProspective, observational, multicenter study.Setting70 Spanish ICUs.Patients And Participants1711 patients with AMI and representative of Spanish ICUs.Measurements And ResultsAPACHE III score, APACHE III system probability of death (APACHE III probability), SAPS II score and in-hospital mortality were noted for each patient. Two hundred and twenty three (13.0 %) patients died in the hospital. The sensitivity (+/- SE), specificity (+/- SE), and accuracy (+/- SE) for the APACHE III score were, respectively, 75.8 +/- 2.9, 75.9 +/- 1.1, and 75.9 +/- 1.0. The corresponding figures for APACHE III probability were 75.3 +/- 2.9, 79.2 +/- 1.1, and 78.7 +/- 1.0, and for SAPS II 72.2 +/- 3.0, 75.9 +/- 1.1, and 75.4 +/- 1.0.ConclusionsThe results indicate good discrimination by the three tests. APACHE III probability shows a statistically significant improvement in accuracy and specificity when compared with the two scores.

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