Validation of a severity of illness score (APACHE II) in a surgical intensive care unit.

The intensive care unit is an important resource for the treatment of patients needing medical and surgical care for complicated diseases. The diversity of diseases and the difference in arrangements between hospitals providing such care have limited the precision of evaluations of intensive care. We have measured the admission characteristics and hospital mortality of 598 consecutive patients admitted to our Surgical Intensive Care Unit (SICU) using a severity of disease classification system (APACHE II) on the first day of admission. Hospital outcome details were available on 87% of the SICU patients. The overall mortality was 21.7%, mean APACHE score for survivors and non-survivors was 14.2 and 22.4, and their risk of death was 21.1% and 54.1%. The APACHE II scoring system provided an excellent means of classification, with a higher sensitivity and specificity.