External validation of the acute physiology and chronic health evaluation II in Korean intensive care units

Jae Yeol Kim, So Yeon Lim, Kyeongman Jeon, Younsuck Koh, Chae Man Lim, Shin Ok Koh, Sungwon Na, Kyoung Min Lee, Byung Ho Lee, Jae Young Kwon, Kook Hyun Lee, Seok Hwa Yoon, Jisook Park, Gee Young Suh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: This study was designed to validate the usefulness of the Acute Physiology and Chronic Health Evaluation (APACHE) II for predicting hospital mortality of critically ill Korean patients. Materials and Methods: We analyzed data on 826 patients who had been admitted to nine intensive care units and were included in the Fever and Antipyretics in Critical Illness Evaluation study cohort. Results: Among the patients enrolled, 62% (512/826) were medical and 38% (314/826) were surgical patients. The median APACHE II score was 17 (11 to 23 interquartile range), and the hospital mortality rate was 19.5%. Age, underlying diseases, medical patients, mechanical ventilation, and renal replacement therapy were independently associated with hospital mortality. The calibration of APACHE II was poor (H=57.54, p<0.0001; C=55.99, p<0.0001), and the discrimination was modest [area under the receiver operating characteristic (aROC)=0.729]. Calibration was poor for both medical and surgical patients (H=63.56, p<0.0001; C=73.83, p<0.0001, and H=33.92, p<0.0001; C=33.34, p=0.0001, respectively), while discrimination was poor for medical patients (aROC=0.651) and modest for surgical patients (aROC=0.704). At the predicted risk of 50%, APACHE II had a sensitivity of 36.6% and a specificity of 87.4% for hospital mortality. Conclusion: For Koreans, the APACHE II exhibits poor calibration and modest discrimination for hospital mortality. Therefore, a new model is needed to accurately predict mortality in critically ill Korean patients.

Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalYonsei Medical Journal
Volume54
Issue number2
DOIs
StatePublished - 1 Mar 2013

Fingerprint

APACHE
Intensive Care Units
Hospital Mortality
Critical Illness
ROC Curve
Calibration
Antipyretics
Renal Replacement Therapy
Mortality
Artificial Respiration
Fever

Keywords

  • APACHE II
  • Calibration
  • Discrimination
  • Illness severity
  • Intensive care units

Cite this

Kim, Jae Yeol ; Lim, So Yeon ; Jeon, Kyeongman ; Koh, Younsuck ; Lim, Chae Man ; Koh, Shin Ok ; Na, Sungwon ; Lee, Kyoung Min ; Lee, Byung Ho ; Kwon, Jae Young ; Lee, Kook Hyun ; Yoon, Seok Hwa ; Park, Jisook ; Suh, Gee Young. / External validation of the acute physiology and chronic health evaluation II in Korean intensive care units. In: Yonsei Medical Journal. 2013 ; Vol. 54, No. 2. pp. 425-431.
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abstract = "Purpose: This study was designed to validate the usefulness of the Acute Physiology and Chronic Health Evaluation (APACHE) II for predicting hospital mortality of critically ill Korean patients. Materials and Methods: We analyzed data on 826 patients who had been admitted to nine intensive care units and were included in the Fever and Antipyretics in Critical Illness Evaluation study cohort. Results: Among the patients enrolled, 62{\%} (512/826) were medical and 38{\%} (314/826) were surgical patients. The median APACHE II score was 17 (11 to 23 interquartile range), and the hospital mortality rate was 19.5{\%}. Age, underlying diseases, medical patients, mechanical ventilation, and renal replacement therapy were independently associated with hospital mortality. The calibration of APACHE II was poor (H=57.54, p<0.0001; C=55.99, p<0.0001), and the discrimination was modest [area under the receiver operating characteristic (aROC)=0.729]. Calibration was poor for both medical and surgical patients (H=63.56, p<0.0001; C=73.83, p<0.0001, and H=33.92, p<0.0001; C=33.34, p=0.0001, respectively), while discrimination was poor for medical patients (aROC=0.651) and modest for surgical patients (aROC=0.704). At the predicted risk of 50{\%}, APACHE II had a sensitivity of 36.6{\%} and a specificity of 87.4{\%} for hospital mortality. Conclusion: For Koreans, the APACHE II exhibits poor calibration and modest discrimination for hospital mortality. Therefore, a new model is needed to accurately predict mortality in critically ill Korean patients.",
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author = "Kim, {Jae Yeol} and Lim, {So Yeon} and Kyeongman Jeon and Younsuck Koh and Lim, {Chae Man} and Koh, {Shin Ok} and Sungwon Na and Lee, {Kyoung Min} and Lee, {Byung Ho} and Kwon, {Jae Young} and Lee, {Kook Hyun} and Yoon, {Seok Hwa} and Jisook Park and Suh, {Gee Young}",
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Kim, JY, Lim, SY, Jeon, K, Koh, Y, Lim, CM, Koh, SO, Na, S, Lee, KM, Lee, BH, Kwon, JY, Lee, KH, Yoon, SH, Park, J & Suh, GY 2013, 'External validation of the acute physiology and chronic health evaluation II in Korean intensive care units', Yonsei Medical Journal, vol. 54, no. 2, pp. 425-431. https://doi.org/10.3349/ymj.2013.54.2.425

External validation of the acute physiology and chronic health evaluation II in Korean intensive care units. / Kim, Jae Yeol; Lim, So Yeon; Jeon, Kyeongman; Koh, Younsuck; Lim, Chae Man; Koh, Shin Ok; Na, Sungwon; Lee, Kyoung Min; Lee, Byung Ho; Kwon, Jae Young; Lee, Kook Hyun; Yoon, Seok Hwa; Park, Jisook; Suh, Gee Young.

In: Yonsei Medical Journal, Vol. 54, No. 2, 01.03.2013, p. 425-431.

Research output: Contribution to journalArticle

TY - JOUR

T1 - External validation of the acute physiology and chronic health evaluation II in Korean intensive care units

AU - Kim, Jae Yeol

AU - Lim, So Yeon

AU - Jeon, Kyeongman

AU - Koh, Younsuck

AU - Lim, Chae Man

AU - Koh, Shin Ok

AU - Na, Sungwon

AU - Lee, Kyoung Min

AU - Lee, Byung Ho

AU - Kwon, Jae Young

AU - Lee, Kook Hyun

AU - Yoon, Seok Hwa

AU - Park, Jisook

AU - Suh, Gee Young

PY - 2013/3/1

Y1 - 2013/3/1

N2 - Purpose: This study was designed to validate the usefulness of the Acute Physiology and Chronic Health Evaluation (APACHE) II for predicting hospital mortality of critically ill Korean patients. Materials and Methods: We analyzed data on 826 patients who had been admitted to nine intensive care units and were included in the Fever and Antipyretics in Critical Illness Evaluation study cohort. Results: Among the patients enrolled, 62% (512/826) were medical and 38% (314/826) were surgical patients. The median APACHE II score was 17 (11 to 23 interquartile range), and the hospital mortality rate was 19.5%. Age, underlying diseases, medical patients, mechanical ventilation, and renal replacement therapy were independently associated with hospital mortality. The calibration of APACHE II was poor (H=57.54, p<0.0001; C=55.99, p<0.0001), and the discrimination was modest [area under the receiver operating characteristic (aROC)=0.729]. Calibration was poor for both medical and surgical patients (H=63.56, p<0.0001; C=73.83, p<0.0001, and H=33.92, p<0.0001; C=33.34, p=0.0001, respectively), while discrimination was poor for medical patients (aROC=0.651) and modest for surgical patients (aROC=0.704). At the predicted risk of 50%, APACHE II had a sensitivity of 36.6% and a specificity of 87.4% for hospital mortality. Conclusion: For Koreans, the APACHE II exhibits poor calibration and modest discrimination for hospital mortality. Therefore, a new model is needed to accurately predict mortality in critically ill Korean patients.

AB - Purpose: This study was designed to validate the usefulness of the Acute Physiology and Chronic Health Evaluation (APACHE) II for predicting hospital mortality of critically ill Korean patients. Materials and Methods: We analyzed data on 826 patients who had been admitted to nine intensive care units and were included in the Fever and Antipyretics in Critical Illness Evaluation study cohort. Results: Among the patients enrolled, 62% (512/826) were medical and 38% (314/826) were surgical patients. The median APACHE II score was 17 (11 to 23 interquartile range), and the hospital mortality rate was 19.5%. Age, underlying diseases, medical patients, mechanical ventilation, and renal replacement therapy were independently associated with hospital mortality. The calibration of APACHE II was poor (H=57.54, p<0.0001; C=55.99, p<0.0001), and the discrimination was modest [area under the receiver operating characteristic (aROC)=0.729]. Calibration was poor for both medical and surgical patients (H=63.56, p<0.0001; C=73.83, p<0.0001, and H=33.92, p<0.0001; C=33.34, p=0.0001, respectively), while discrimination was poor for medical patients (aROC=0.651) and modest for surgical patients (aROC=0.704). At the predicted risk of 50%, APACHE II had a sensitivity of 36.6% and a specificity of 87.4% for hospital mortality. Conclusion: For Koreans, the APACHE II exhibits poor calibration and modest discrimination for hospital mortality. Therefore, a new model is needed to accurately predict mortality in critically ill Korean patients.

KW - APACHE II

KW - Calibration

KW - Discrimination

KW - Illness severity

KW - Intensive care units

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