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Both the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the simplified acute physiology score (SAPS II) underestimated the percentage of patients on mechanical ventilation who would die within six days in this prospective cohort study of 93 patients with acute lung injury. A low or decreasing respiratory system compliance on the sixth day of mechanical ventilation was a better independent predictor of mortality.
RESULT: Decreased respiratory system compliance on the sixth day of mechanical ventilation is a predictor of death in patients with established acute lung injury
Respiratory Research | Apr 22, 2011 (FREE FULL TEXT)
Trauma and critical care scoring systems, including APACHE II, Revised Trauma Scores (RTS) and Trauma Score-Injury Severity Scores (TRISS), also underestimate mortality in patients with vascular trauma. In this retrospective review of 100 patients, 50 with vascular trauma and 50 with non-vascular trauma, the presence of vascular injury was associated with increased mortality in less severely injured patients, based on the three scoring systems. The New York University authors suggest that future trauma algorithms, and the level of care, should be adjusted for vascular trauma patients.
RESULT: Existing trauma and critical care scoring systems underestimate mortality among vascular trauma patients.
Journal of Vascular Surgery (PubMed) | Feb 1, 2011 (Free abstract. Full text $31.50)
Serial blood urea(Drug information on urea) nitrogen (BUN) measurements can predict early mortality from acute pancreatitis as well as APACHE II scores do, judging from this analysis of three prospective cohort studies of more than 1,000 acute pancreatitis patients. The authors have developed a BUN-based assessment algorithm to identify acute pancreatitis patients at increased risk for mortality during the initial 24 hours of hospitalization.
RESULT: Blood Urea Nitrogen in the Early Assessment of Acute Pancreatitis
Archives of Internal Medicine | Apr 11, 2011 (Free abstract. Full text $30)
