J Med Assoc Thai 1997; 80 (3):169

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APACHE II in a Postoperative Intensive Care Unit in Thailand
Lertakyamanee J Mail, Somprakit P , Vorakitpokaton P , Kururattapan S , Udompunturak S , Pensuk S

In order to evaluate the effectiveness of an intensive care unit (ICU), the case-mix has
to be considered. This was a cohort study. By using Acute Physiology and Chronic Health Evaluation
scores (APACHE II score), we evaluated the case-mix and mortality rate of 282 patients
who were treated in our postoperative ICU. The overall mortality rate was 10.6 per cent. Higher
Acute physiology scores and emergency surgery in the presence of chronic health status were
related to higher mortality, but age was not. However, the original APACHE II model could not
precisely predict the mortality of Thai patients. We used stepwise logistic regression to determine
the predictors of death and found the prediction model to be -7.24 + 0.37 (APACHE II
score) + 1.46 (postemergency surgery). The actual mortality for patients with APACHE II score
> 15 in our ICU was higher than that predicted by the original APACHE II model. The causes
of this difference might be difference in methodology, characteris_tics of ICU and the quality of

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