Prognostic Scoring Systems as a Tool to Predict the Clinical Outcomes for Patient with Critical Condition

Mohamed Elmahdy, Noura; Elsenousy, Tahany; Abdallah Abdelatief, Dalia; Mohamed Maarouf, Dina

doi:10.21608/ejhc.2022.270426

Prognostic Scoring Systems as a Tool to Predict the Clinical Outcomes for Patient with Critical Condition

Document Type : Original Article

Authors

¹ BSc of Nursing from British University in Egypt

² Professor in Critical Care Nursing Department, Faculty of Nursing- Ain Shams University, Egypt

³ Assist Professor in Medical Surgical Nursing Department, Faculty of Nursing- Ain Shams University, Egypt

⁴ Assist Professor in Critical Care Nursing Department, Faculty of Nursing- Ain Shams University, Egypt

10.21608/ejhc.2022.270426

Abstract

Background: ICU scoring systems allowed an assessment of the severity of disease and death
prediction. The use of prognostic scoring system to predict possibility of mortality and evaluating
outcomes in critically ill patients is an important in the modern evidence –based critical care. Aim:
This study aimed to assess prognostic scoring systems as a tool to predict the clinical outcomes for
patient with critical condition. Design: A descriptive exploratory design was conducted to achieve
the aim of this study. Setting: The study was carried out in intensive care units (ICUs) of Ain
Shams University Hospital (surgical, Internal medicine and neurological ICUs) affiliated to Ain
Shams University, Cairo-Egypt. Study subject: A Purposive sample of (200) patients admitted to
the previous mentioned setting. Tools of data collection; were consisted of patient assessment tool,
APACHE IV, SAPS III, SOFA and MPM II and the last tool was used (at admission MPM0, MPM
at 24hrs, MPM at 48hrs and MPM at 72 hrs). Results: Revealed that, more than half of studied
patients were male, with age ranged from 23.00 to 80.00 years old. The overall mortality observed
was 25% in all the patients. APACHE IV predicted mortality rate sensitivity and specificity were
94.11% and 95.97% respectively. Also, APACHE IV score had moderate positive correlation
between predicated ICU length of stay and real ICU length of stay. Conclusion: APACHE IV
established the best discrimination and superior calibration makes it the most appropriate model for
comparisons of mortality rates with the other scores in ICU. APACHE IV score was better than
SAPS III, SOFA and MPM II scores as they were significantly higher between non-survivors to
predict mortality and length of stay among ICUs patients. Recommendations: Applications of
APACHE IV score system to assess of all admitted patient to ICU in nursing assessment

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