Scoring Systems in ICU and Malnutrition

Critical Illness Clinical Trial

Official title:

Combination of APACHE Scoring Systems With Adductor Pollicis Muscle Thickness for the Prediction of Mortality in ICU

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03318965
• Other study ID #: 1374103
• Status: Completed
• Phase: N/A
• First received: October 10, 2017
• Last updated: October 20, 2017
• Start date: June 2014
• Est. completion date: November 2016

Study information

• Verified date: October 2017
• Source: Shahid Beheshti University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The objective of the present study was to compare the ability of acute physiology and chronic health evaluation (APACHE) scoring systems with the combination of an anthropometric variable score "adductor pollicis muscle (APM) thickness" to the APACHE systems in predicting mortality in the ICU. Three hundred and four patients enrolled in this prospective observational study. The APM thickness in dominant hand and APACHE II and III scores were measured for each patient upon admission. Given scores for the APM thickness, were added to APACHE score systems to make two composite scores of APACHE II- APM and APACHE III- APM. The accuracy of the two composite models and APACHE II and III systems in predicting mortality of patients was compared using area under the ROC curve.

Based on the study results, the area under the ROC curves improved in composite models. Therefore, it seemed that considering anthropometric variables may improve prediction of mortality in APACHE systems.

Description:

The baseline medical history, physical examination, Acute Physiology and Chronic Health Evaluation score II and III (APACHE) were recorded for all patients. All data were collected by a single physician. The APACHE II and III scores were gathered using the method presented by Knaus. The dominant hand APM thickness (as reported by the patient, or the relative) was assessed by Caliper (Vogel, Germany) in the emergency room or at the time of the ICU admission. To estimate weight for the APM thickness, multivariate logistic regression analysis was used to determine the relation between mortality and the APM thickness while controlling for other physiologic variables (12 physiologic variables for APACHE II and 18 physiologic variables for APACHE III).The area under the receiver-operating curves (ROC curve) to predict mortality was used to compare APACHE II, APACHE III, APACHE II- APM and APACHE III- APM systems.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 304
• Est. completion date: November 2016
• Est. primary completion date: November 2016
• Gender: All
• Age group: 16 Years and older

Eligibility

Inclusion Criteria:

• Older than 16 years of age

Exclusion Criteria:

• Splints, in the upper extremities

• Casts in the upper extremities

• Edema in the upper extremities

• Patients with readmission during the study period

• Those transferred from other ICUs

Related Conditions & MeSH terms

• Critical Illness

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Shahid Beheshti University

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Prediction of Mortality	Mortality prediction by APACHE -APM	First day of ICU admission