APPLICATION OF A PROGNOSTIC SCORING SYSTEM TO CRITICALLY-ILL PATIENTSIN A SMALL MILITARY FACILITY

Two hundred one consecutive adult admissions to a 3-bed Special Care U nit in a 25-bed military hospital were scored using APACHE II (Acute P hysiology and Chronic Health Evaluation). Outcome measures included AP ACHE II scores and mortality predictions; active intensive care interv entions; transfers for specialized care; and mortality. Although highe r scores generally reflected the need for intensive care intervention, admissions with nondiagnostic chest pain had scores that did not accu rately predict their course. This finding could be explained by bias i n the original APACHE case mix and by the need for further subclassifi cation of cardiovascular disease. APACHE II scoring can be applied in small intensive care settings. Scoring criteria and logistic regressio n equations may need to be customized accordingly.