Current Thoracic Surgery 0 , Vol 4 , Issue 1
The comparison of the Acute Physiology and Chronic Health Evaluation II, Sequential Organ Failure Assessment and American Society of Anesthesiologists physical status classification scores in the prediction of morbidity and mortality after lung surgery
Yücel Özgür1,Cemal Aker2
1Department of Anesthesiology and Reanimation, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
2Department of Thoracic Surgery Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turk
DOI : 10.26663/cts.2021.0022 Viewed : 54 - Downloaded : 41 Background: This study compared three commonly used scoring systems, the Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and American Society of Anesthesiologists physical status classification (ASA), in the prediction of post-operative mortality and morbidity after lung resection.

Materials and Methods: Adult patients admitted to the surgical intensive care unit (ICU) after lung resection between January 2018 and January 2020 were retrospectively evaluated.

Results: The study included 509 patients with a mean (SD) age of 59.9 (11.7) years; 421 of the patients were men (82.7%). The average ICU length of stay was 4.2 ± 6.9 days. Preoperative ASA scores were I-II in 73.5% and III-IV in 26.5% of the patients. The mean (SD) postoperative APACHE II score was 9.42 (4.23) and SOFA score was 1.04 (2.08). The area under the curve (AUC) in receiver operating characteristic analysis of postoperative complications was 0.772 for APACHE II and 0.690 for SOFA. The AUC values of APACHE II and SOFA scores for mortality were 0.925 and 0.944, respectively.

Conclusions: Our comparison of these scoring systems showed that SOFA was the best predictor of morbidity and mortality after lung resection. SOFA predicted the development of complications significantly better than both APACHE II and ASA. SOFA also predicted mortality better than ASA and APACHE II, although the difference was not significant for APACHE II. SOFA and APACHE II scores can be used to predict mortality and morbidity in patients lung resection surgery. Keywords : Acute Physiology and Chronic Health Evaluation II Score, Sequential Organ Failure Assessment Score, complication, mortality, lung resection