Open AccessStatistical validation of a severity of illness measure.
Author(s) -
Douglas P. Wagner,
William A. Knaus,
Elizabeth A. Draper
Publication year - 1983
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.73.8.878
Subject(s) - medicine , logistic regression , intensive care unit , apache ii , emergency medicine , severity of illness , medical diagnosis , intensive care medicine , multivariate statistics , multivariate analysis , statistics , pathology , mathematics
This paper provides statistical detail on the predictive power of a new severity of illness scale--APACHE (Acute Physiology and Chronic Health Evaluation)--on 833 consecutive medical admissions to an intensive care unit (ICU). In a multivariate logistic regression analysis of routine physiologic and other data obtained within 24 hours of ICU admission, severity of illness and age were significantly (p less than .0001) related to survival. Using the estimated 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 associated 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.