short- and long-term outcome of liver transplant patients APACHE II 
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 short- and long-term outcome of liver transplant patients APACHE II

Subject: INFO:APACHE II Predicts Long-Term

WESTPORT, Feb 14 (Reuters Health) - A commonly used
mortality prediction system, Acute Physiology and Chronic
Health Evaluation II (APACHE II), can predict the short- and
long-term outcome of liver transplant patients.

"APACHE II may be useful for long-term mortality prediction
in other critically ill populations," Dr. Derek C. Angus from
the University of Pittsburgh, Pennsylvania, and colleagues
suggest in the January issue of Critical Care Medicine.

The researchers evaluated the relationship between APACHE
II score and outcome in 599 liver transplant patients. They
note that APACHE II had not previously been rigorously
tested in liver recipients.

"Overall, the APACHE II score was strongly predictive of
hospital mortality," the researchers conclude. "Although
designed only to predict hospital mortality, APACHE II score
was also highly predictive of 1-yr mortality." The score also
predicted graft failure at 3 months and 1 year.

Dr. Angus told Reuters Health that "for the critically ill our
study shows that, at least in one group of patients, acute
physiologic derangement retains prognostic significance for up
to 1 year after ICU admission. We believe this has important
implications for post-discharge patient management."

"Our study has implications for transplant recipients and for
the critically ill in general," he added. "With the scarcity of
organs, evaluating which are the best centers is currently a
national priority. Also, the majority of deaths with liver
transplant occur during the post-surgery hospitalization.
Accurate prediction during this period will aid in patient
management decisions and family counseling."

"One important area of risk prediction is to predict longer
outcomes than just hospital survival. This study provides some
help in that direction," Dr. Angus said. But, he added, "it is a
single-center study. Whether the results can be generalized,
therefore, can only be speculated."

In the journal, the investigators caution that they used orthoptic
liver transplant-specific coefficients in making their
calculations. They add that "the APACHE II score will be
most useful when predicting outcome for groups of patients
(eg, in clinical trials or in comparisons between different
centers) as opposed to individuals."



Sun, 11 Aug 2002 03:00:00 GMT
 
 [ 1 post ] 

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