TY - JOUR
T1 - Failure of APACHE II alone as a predictor of mortality in patients receiving total parenteral nutrition
AU - Hopefl, A. W.
AU - Taaffe, C. L.
AU - Herrmann, V. M.
PY - 1989/1/1
Y1 - 1989/1/1
N2 - We followed prospectively over 5 months all medical and surgical ICU patients placed on total parenteral nutrition (TPN) and recorded their Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on the day of admission, on the day TPN was started, length of time in ICU before TPN was started, and the number of days TPN was administered. Sixty-one patients (15 to 82 yr) had an inhospital mortality of 47%. The APACHE II score was significantly higher for nonsurvivors vs. survivors both on the day of admission (24.4 ± 9.6 vs. 18.4 ± 6.5; p < .003) and also on the day TPN was started (21 ± 8.6 vs. 16.4 ± 5.6; p < .002). However, at a 60% risk of dying, specificity was 96.9% and sensitivity 27.6%. The mean number of days before TPN was started was 3.2 and mean number of days on TPN was 9.2 (p = NS). We conclude that calculation of APACHE II score either on ICU admission or on the day TPN is considered does not seem useful in identifying patients who will not benefit from TPN.
AB - We followed prospectively over 5 months all medical and surgical ICU patients placed on total parenteral nutrition (TPN) and recorded their Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on the day of admission, on the day TPN was started, length of time in ICU before TPN was started, and the number of days TPN was administered. Sixty-one patients (15 to 82 yr) had an inhospital mortality of 47%. The APACHE II score was significantly higher for nonsurvivors vs. survivors both on the day of admission (24.4 ± 9.6 vs. 18.4 ± 6.5; p < .003) and also on the day TPN was started (21 ± 8.6 vs. 16.4 ± 5.6; p < .002). However, at a 60% risk of dying, specificity was 96.9% and sensitivity 27.6%. The mean number of days before TPN was started was 3.2 and mean number of days on TPN was 9.2 (p = NS). We conclude that calculation of APACHE II score either on ICU admission or on the day TPN is considered does not seem useful in identifying patients who will not benefit from TPN.
UR - http://www.scopus.com/inward/record.url?scp=0024334002&partnerID=8YFLogxK
U2 - 10.1097/00003246-198905000-00007
DO - 10.1097/00003246-198905000-00007
M3 - Article
C2 - 2495897
AN - SCOPUS:0024334002
SN - 0090-3493
VL - 17
SP - 414
EP - 417
JO - Critical care medicine
JF - Critical care medicine
IS - 5
ER -