medical decision support medical decision support
Sign In

Model of Angstwurm et al for Predicting Mortality in the ICU Using the APACHE II and ISTH DIC Scores

Purpose: To predict the risk of mortality for a patient with sepsis using the APACHE II and ISTH DIC scores as reported by Angstwurm et al.

Description

Angstwurm et al used both the APACHE II and ISTH DIC scores to predict mortality for patients in the intensive care unit (ICU). This can help identify a patient who may benefit from more aggressive management. The authors are from Ludwig-Maximilans Universitat, Klinikum Mannheim, and University Hospital Muenchen in Germany.


Patient selection for prediction: sepsis

 

Parameters determined on admission to the ICU:

(1) APACHE II score

(2) International Society of Thrombosis and Hemostasis (ISTH) DIC score (see 04.18.04)

 

APACHE II

ISTH DIC Score

Mortality Rate

<= 15

0, 1 or 2

5%

 

3 or 4

15%

 

5 or 6

43%

 

7 or 8

100%

16 - 30

0, 1 or 2

20%

 

3 or 4

33%

 

5 or 6

33%

 

7 or 8

100%

> 30

0, 1 or 2

50%

 

3 or 4

67%

 

5 or 6

75%

 

7 or 8

100%

 

Other conditions showing a link with the DIC score (Table 2):

(1) liver disease (hepatic failure or esophageal varices)

(2) acute pancreatitis

(3) cancer

(4) postoperative

 

Limitation:

• Performance using both scores was better in patients with acute infection/sepsis.

• Some variation in mortality will be seen due to underlying disease, patient characteristics and local management.


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10