Clinical application of disease severity and prognosis evaluation system in sepsis patients

Objective To compare the clinical values of acute physiology and chronic health evaluation II（APACHE II） and sepsis-related organ failure assessment（SOFA） scoring systems for predicting the severity and prognosis of sepsis patients. Methods Clinical data about 52 sepsis patients were collected within 24h,and on days 3,5,7,10,14 after they were admitted to our hospital.Scores of their disease severity according to the APACHE II and SOFA scoring systems were compared. Results Of the 52 sepsis patients,16 died with a mortality rate of 30.8%.The APACHE II score was 12.0±6.9,16.8±6.8,and 23.1±5.6 for patients with sepsis,severe sepsis and severe sepsis shock,respectively（P=0.002）,while the SOFA score was 2.9±2.1,5.9±3.1,and 11.6±2.9 for patients with sepsis,severe sepsis and severe sepsis shock,respectively（P＜0.001）.The patients were divided into survival group（≥28d） and death group（＜28d）.The APACHE II and SOFA scores were higher for death group（n=16） than for survival group（n=36）（14.9±7.1 vs 19.7±7.3 and 4.6±3.2 vs 8.8±4.0,P＜0.001）.The SOFA score decreased in survival group and increased in death group with the disease course.The SOFA score for predicting death in death group according to the area under the receiver operating characteristic curve was 0.795（95% CI=0.662-0.929）,which was higher than that（0.670,95% CI=0.514-0.826） of the APACH II score. Conclusion SOFA score is better than APACHE II score for predicting the severity and prognosis of sepsis patients.