원저 : APACHE 3 를 이용한 내과 중환자실 환자의 질병 중증도 평가

Objectives : In order to quantify the risk for medical intensive care unit (ICU) patients and to establish the guideline for decision making by using Acute Physiology and Chronic Health Evaluation (APACHE) III score. Methods : Total 204 medical ICU patients from July-1993 to September-1993 were enrolled to this study. Patients were categorized into subgroups by major disease cateogories, We measured acute physiologic variables, age, comorbidities, and chronic health status according to the APACHE III scoring system. Logistic regression analysis was done to determine the relationship between APACHE III score and death risk. Results : The overall mortality rate of 204 medical ICU patients was 28.4% (58/204). The majority of patients showed standard distribution over 17~72 APACHE III points. The main APACHE III point of survived group(n=146) was significantly lower than that of non-survived group(n=58), 43.6 vs 69.4, respectively(p<0.01). Logistic regression analysis about the relationship between APACHE III score and death risk gave the equation like this: logn R/1-R= 0.04314×(APACHE III)-3.488 According to this equation, the estimated risk of death was over 50% at the point range of 80~85 and over 90% at 130~135. Conclusion: APACHE IU scoring system could be a useful guideline to predict and to evaluate the outcome in medical ICU patients and it would aid us in clinical decision making and proper management of ICU patients.