Trial reportInjury2009
Revisiting the validity of APACHE II in the trauma ICU: improved risk stratification in critically injured adults.
Trial report in Injury, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed.
- Effect of Dexmedetomidine on Posttraumatic Stress Disorder in Patients Undergoing Emergency Trauma Surgery: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Randomized Controlled Study on Safety and Feasibility of Transfusion Trigger Score of Emergency Operations.Chinese medical journal · 2015Trial
- Review
- Article
- The clinical profile of abdominopelvic injury and the determinants of length of stay and mortality in the intensive care unit of a tertiary hospital.The Southern African journal of critical care : the official journal of the Critical Care Society · 2025Article
- Neutrophil-derived long noncoding RNA IL-7R predicts development of multiple organ dysfunction syndrome in patients with trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Applicability of Anatomic and Physiologic Scoring Systems for the Prediction of Outcome in Polytraumatized Patients with Blunt Aortic Injuries.Diagnostics (Basel, Switzerland) · 2021Article
- Age, Frailty, Resuscitation and Intensive Care: With Reference to COVID-19.Geriatrics (Basel, Switzerland) · 2021Article
- Administrative and Claims Data Help Predict Patient Mortality in Intensive Care Units by Logistic Regression: A Nationwide Database Study.BioMed research international · 2020Article
- No effect of hyperoxia on outcome following major trauma.Open access emergency medicine : OAEM · 2019Article
- Multiclassifier Systems for Predicting Neurological Outcome of Patients with Severe Trauma and Polytrauma in Intensive Care Units.Journal of medical systems · 2017Article
- Evaluation of Probability of Survival using APACHE II & TRISS Method in Orthopaedic Polytrauma Patients in a Tertiary Care Centre.Journal of clinical and diagnostic research : JCDR · 2015Article
- The ability of two scoring systems to predict in-hospital mortality of patients with moderate and severe traumatic brain injuries in a Moroccan intensive care unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2014Article
- Sex- and diagnosis-dependent differences in mortality and admission cytokine levels among patients admitted for intensive care.Critical care medicine · 2014Observational
- Diarrhoea in the ICU: respective contribution of feeding and antibiotics.Critical care (London, England) · 2013Observational
- Feasibility and early outcomes of intensivist-led critical care after major trauma in the Korean ICU.Yonsei medical journal · 2013Article
- Using the E-PASS scoring system to estimate the risk of emergency abdominal surgery in patients with acute gastrointestinal disease.Surgery today · 2011Article
- Diagnosis-dependent relationships between cytokine levels and survival in patients admitted for surgical critical care.Journal of the American College of Surgeons · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundQuality and benchmarking initiatives highlight the need for accurate stratified risk adjustment. The stratification of trauma patients has relied on scores specific to trauma populations. While the Acute Physiologic and Chronic Health Evaluation (APACHE) II score has been considered "invalid" in the trauma population, we hypothesized that APAHCE II would more accurately predict outcomes in critically injured patients in whom commonly used trauma scores have inherent limitations.
methodsA prospective cohort of critically injured patients was enrolled. Severity scores and their sub-components were collected, and in-hospital mortality was assessed. The area under the receiver operating characteristic (AUROC) curve was used to determine the predictive value of each score. Logistic regression estimated the odds of death associated with incremental changes in severity scores and their subcomponents.
results1019 patients were available for analysis. APACHE II was the best predictor of mortality (AUROC 0.77 versus AUROC 0.54 for ISS and 0.64 for TRISS). A unit increase in APACHE II was associated with an OR of death of 1.18 (95% CI 1.14-1.22). The components of APACHE II that contributed the most to its accuracy included temperature, serum creatinine and the Glasgow Coma Scale (GCS).
conclusionCritically injured patients have physiologic derangements not accurately accounted for by commonly used trauma scores. In this subset a more general ICU scoring system is useful for risk adjustment for research, administrative and quality improvement purposes.
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