Statistical Validation of a Severity of Illness Measure.

APACHE (Disease classification system); INTENSIVE care units; LOGISTIC regression analysis; AGE; DEATH rate; ESTIMATES

This paper provides statistical detail on the predictive power of a new severity of illness scale--APACHE (Acute Physiology and Chronic Health Evolution)--on 833 consecutive medical admissions to an intensive care Unit (ICU). In a multivariate logistic regression analysis of routine physiology and other data obtained within 24 hours of ICU admission severity of illness and age were significantly (p < .0001) related to survival. Using the estimates equation to forecast death rates for independent data. APACHE allowed accurate estimates of death rates for groups of patients whose mortality at hospital discharge varied from 3 to 80 per cent. The Acute Physiology Score of APACHE is also strongly and significantly associates with outcome within a number of specific cardiovascular, neurologic, respiratory, and gastrointestinal diagnoses. After multi-institutional validation studies. APACHE could prove useful in a wide range of studies involving acutely ill patients. [ABSTRACT FROM AUTHOR]

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