The association between the APACHE-II scores and age groups for predicting mortality in an intensive care unit: a retrospective study

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DOI: http://dx.doi.org/10.2478/rjaic-2019-0008

Ipek Saadet Edipoglu, Behiye Dogruel, Sevda Dizi, Melis Tosun, Nahit Çakar

Department of Anaesthesiology and Reanimation, Acibadem University School of Medicine, Istanbul, Turkey

Background and Aims: In this study, we aimed to evaluate whether the age or the APACHE-II score was a better predictor of mortality in each group. The secondary objective was to investigate the factors affecting the mortality in each individual age group.
Methods: We designed this retrospective study between 2016-2017. Age groups were classified into 3 classes: Patients < 60 years were Group 1, patients between 60-70 years were Group 2, and patients > 70 years were Group 3. We recorded patients’ age, ICU indication, demographic data, APACHE-II, ASA, length of hospital stays and mortality.
Results: We analysed 150 patients and reported mortality for 58 patients (38.7%). We did not detect any association between age and mortality for all groups. ASA, length of ICU stays and predicted mortality rate, were significantly higher for exitus patients (p < 0.001). The ROC curve for the APACHE-II score, with a cut-off point of 23, demonstrated 74.14% sensitivity, 60.87% specificity, an area under the curve (AUC) of 67.3%, with 4.5% standard deviation (SD). The ODDS ratio for APACHE-II scores was 4.459 (95% CI: 2.167-9.176). For the adjusted mortality rate, ROC analysis identified a cut-off of 60.8 with 70.69% sensitivity, 52.17% specificity, AUC of 61.2% and 4.6% SD. The ODDS ratio for the adjusted mortality rate was 2.631 (95% CI: 1.309-5.287).
Conclusion: We could not demonstrate any correlation between age and mortality. We consider APACHE-II as a valuable scoring system to predict mortality. We do not consider age as a predictor of mortality. Therefore, we do not suggest its use as a sole prognostic marker in ICU patients.
Keywords: APACHE-II, age, mortality