Wykorzystanie skal niewydolności wielonarządowej APACHE II, MODS, SAPS II i SOFA w ocenie stanu chorych w okresie poresuscytacyjnym

Andrzej Mysiak, Małgorzata Kobusiak-Prokopowicz

Summary
Background. In this prospective study, we used the organ dysfunction scores for assessment of the post-resuscitation clinical status of cardiac arrest victims. Methods. 96 adult CPR survivors who were treated in a cardiologic intensive care unit were allocated to two groups: group I – 38 patients who left the hospital alive, and group II – 58 patients who died in hospital. Patients of group II were further allocated to three subgroups: IIa – 9 patients who died within 48 hours after resuscitation, group IIb – 10 patients who died within 7 days after CPR, and group IIc – 32 patients who survived longer than 7 days, but ultimately died. 31 cardiac patients, who had not suffered a cardiac arrest, served as controls. All patients were rated during 7 consecutive days after CPR using APACHE II, MODS, SAPS II and SOFA scales. Results. The mean scores in all patients of the group II were significantly (p<0.05-p<0.001) higher than those in group I or in the control group. The APACHE and SAPS scores of patients of the subgroup IIa were higher than in all other subgroups (IIa>IIb>IIc). The scores in groups IIb and IIc decreased significantly over 7 days of treatment. Conclusions. All assessment scales used, were of significant clinical value in predicting the outcome of cardiac arrest victims. Scales APACHE II and SAPS II were more reliable for early assessment, compared to MODS and SOFA.

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