Abstract

RODRIGUEZ BATISTA, René; CASTANER MORENO, Juan  and  GONZALEZ MUNOZ, Berta. Correlation among the evaluation by APACHE-II system, renal function evolution and survival of critical patients. Rev Cub Med Mil [online]. 2001, vol.30, suppl.5, pp.34-40. ISSN 0138-6557.

The patients admitted to the polyvalent ICU of “Dr Luis Díaz Soto” Higher Institute of Military Medicine were analyzed to find out the effectiveness of the evaluating system APACHE-II not only as a survival predictor but also as acute renal failure risk predictor. The group of studied patients included multitrauma (63,3%), complicated surgical (30%) and serious acute poisoned (6,7%). The APACHE-II evaluation made at admission indicated 10 or more scores in 70% of the studied patients, with an average of 13,3 scores. Twenty-five patients died (41,6%). This outcome increased with APACHE-II scoring and reached a mortality rate of 78,5% in those achieving 20 or more scores. Acute renal failure (ARF) affected 41,6% of patients, being the more frequent in acute poisoned (75%) and complicated surgical (50%) patients. The onset of ARF as an evolving complication was more common when APACHE-II index was higher since it affected 92,9% of those who reached 20 or more. The relationship of ARF and death was significant in complicated surgical and in multitrauma patients. 23.3% of the deceased had ARF, but 56% of the patients who developed this disorder died. These patients were affected by sepsis and multi organ failure (MOF). The study was aimed at confirming the usefulness of APACHE-II system, prognostic indicator of studied critical patients both as survival and ARF onset and development predictor.

Keywords : APACHE; KIDNEY FAILURE, CHRONIC [diagnosis]; INTENSIVE CARE UNITS.

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